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TABLE OF CONTENTS
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...............................................Foreword by Dr. Tom Oeltmann i
.........................................The Decision Pursue a Career in Medicine 1
.......................................The Premedical Advising Program at Vanderbilt 3
.......................................The Premedical Program of Study at Vanderbilt
..................................................Premedical Requirements 5
.....................................................Course Selection 5
Selection of a Major : 7
.............................................................The Admission Process
.............................................................Factors in Medical School Selection 9
.............................................................Overall Academic Record 9
.............................................................Quality Point Ratio 9
.............................................................Special Cases 12
.............................................................MCAT I 3
.............................................................Extracurricular Activities and Work Experience 14
.............................................................The Evaluation 15
.............................................................Buckley Amendment 16
............................................................The Application
............................................................Where to Apply 17
............................................................AMCAS 18
............................................................Timetable 19
............................................................Suppordag Documents 19
............................................................The Interview 20
............................................................Financing a Medical Educaffon 22
............................................................If You Are Not Selected
............................................................Reapplication 25
............................................................Foreign Medical Schools 25
............................................................Career Alternatives 27
............................................................Medical School Policies and Special Programs
............................................................Early Acceptance at Vanderbilt 28
............................................................Early Admission 28
............................................................Notincation 28
............................................................Joint Degree Programs 29
............................................................Minorities andWomenApplicants 29
............................................................Accelerated Programs 30
............................................................Conclusions 3 1
....APrENDIX
................................................I. Timetable for Premedical Students 33
................................................II. Suggested Sequences for Premedical Courses at Vanderbilt 34
................................................III. U.S. Medical School Applicants, 1994 Entering Class 35
................................................IV. Vanderbilt Acceptance Data-1995 40
................................................V. Skull ~ Bones at Vanderbilt 41
................................................VI. Suggested Readmg for Premedical Students 42
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THE DECISION TO PURSUE A CAREER IN MEDICINE
One of the most important decisions that a person will is the choice of a career. This choice win determine to a large extent the lifestyle, earnings, and prestige that a person win enjoy and it win have many other influences that are too numerous to catalog in this brief discussion. A great many young people enter college expecting to become medical doctors but with lime real knowledge of what is involved in the practice of medicine. The role of a physician is unique among the professions. A physician will usually be present when a person is born and when they die, plus during many times of crisis in between. Many students have little real understanding of the trade-offl that are made when choosing medicine as a career goal (and an career decisions involve trade-offl), particularly concerning the pressures and demands made by the profession on its practitioners.
Premedical students should be aware that the competition for admission to medical school is very intense. Dunug the four undergraduate years there win be a great deal of competition from other very bright students and the courses required for admission to medical school win be quite rigorous. There win be an uncertainty and anxiety as the student prepares to take the Medical College Admission Test and decides where to apply for admission to medical school. If you do gain enhance into medical school you can expect a rigorous cirriculmn. In a conventional medical school the M.D. degree requires four years of
study. The first two years, caned the preclinical years, are spent primarily in a classroom setting studying the basic medical sciences. The first year concentrates on the healthy human body with classes in anatomy, biochemistry, physiology, etc. The second year emphasizes human disease with courses in pathology, infectious diseases, pharmacology, etc. At the end of the second year students write Part I of the U. S. Medical Licensing Exam (USMLE), a test taken by an medical students. Most medical schools require passing scores on this test before beginning the "clinical clerkships" in medicine, surgery, pediatrics, psychiatry, obstetrics/gynecology etc. during the third year. The fourth year is a continuation of clinical training, some of it required, but most programs have several electives so that students may gain experience in an area they are considering as a specialty. The third and famth years are spent working with patients in a clinical setting under the supervision of experienced
. . .
pnyslclans.
There is considerable stress on most medical students. Only a few of the numerous reasons for this win be mentioned.
The greatest stress is probably due to the workload. Most medical students agree that the amount of material repoured to be
assimilated goes up by a factor of two or more compared to their workload as undergraduates d''nng the first two years of
preclinical study. During the clinical years pressure generated by constantly working with people who are sick and often dying is
emotionally very difficult for many. Seeing death first-hand makes most students much more aware of their own mortality,
sometimes leading to emotions pressures.
Financing a costly medical education is a problem for many. The typical medical student is now more than $50,000 in
debt upon graduation and many will owe much more in the years ahead. There is pressure and uncertainty as medical students
compete for a spot in a good residency program, and there are the physical and psychological demands made by very long hours
of hard work. These demands do not cease upon completion of residency training as those who are familiar with the long hours
required for the successfi~1 practice of medicine can testify. Such stresses are often difficult for the spouse of a medical student.
Many are unable or unwilling to accept the fact that the demands of the profession must often take precedence over the social
needs of the family for a person in medicine.
The work itself is sometimes unpleasant and can be highly stressful (as anyone who has been involved with trauma cases
win agree). Some of the things that must be done to patients who are often seriously ill or injured win be umpleasant. In some of
the primary care areas (particularly pediatrics and family practice) the work tends to be routine, often unstimulating
intellectually, and sometimes boring. Most of the situations encountered in medicine are not like those seen on television soap
operas.
It is true that a physician win have the expectation of a much better than average income after completion of the many
years of training and the economic hardships that often result from these long years. However, if the primary motivation for
entering the medical profession is to make a great deal of money, certain areas of business such as some fast-growing retail
business or service should be considered instead. If the same amomlt of time and talent is invested in your own business as is
required for a successful medical practice, the economic returns win probably be greater in business than in medicine over the
long run, particularly if the years of lost earnings during the long years of training are considered.
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Many knowledgeable observers believe that the "golden years" of medicine may very wed have been during the 1 960's
and 1 970's. The prestige of the physician is being eroded. Many patients now view their physician as an over-paid professional
who has little personal interest in their wet/-being. One factor contributing to this attitude is the increased specialization in
medicine which rarely results in the formation of long-time associations and friendships which were the rule a generation or two
ago when most people went to their general practitioner for essentially an their health care needs. Rising expectations of the
patient are another reason for increasing lack of trust and even hostility toward the physician. This is a major factor in the
increase in the number of malpractice suits. The years since World War II have seen tremendous advances in the science of
medicine and in the availability of highly effective new drugs and treatments. Many patients now expect their physician to be a
miracle worker and if there is a bad outcome, even through no fault of the physician, the tendency on the part of many is to sue
their doctor for malpractice.
During the past twenty years the cost of medical care has increased at a rate much above the inflation rate, making "cost
containment" a primary concern of legislators and many government officials as wed as private health insurance companies.
Health care reform was the issue that made many headlines during the early days of the Clinton adminis~an, but the package
put together was not passed by congress. The issue has been pronounced dead by some, but by various means the federal
government intends to increase the number of physicians practicing as "generalists" and decrease the number of specialists. This
win make for greater competition to obtain a residency in many specialties, particularly in surgical sub-specialties. Recent
changes in the methods of reimbursement for Medicare and Medicaid patients as wed as those with private insurance has had the
effect of setting fees for physicians. Managed health care is a method that has been proposed to help in keeping down cost.
There has been a large increase in "for profit" hospitals, free standing medical clinics, Health Maintenance Organizations
(HMO's), Preferred Provider Organizations (PPO's) and an ah,~habet soup of other organizations that may very wed change the
way in which physicians are reimbursed from the traditional fee-for-service to some type of prepaid medical care. An increasing
number of physicians win be hired to provide medical service for corporate medical entities, bonging some fundamental changes
in the way medicine is practiced. By the time freshmen entering college today establish their own practices (in 10 or more years)
there may be some rather dramatic changes in the way medicine is practiced.
These comments should not be interpreted as a recommendation to our best students that they should no longer aspire to
careers in medicine. It is an honorable profession that win continue to reward those who have the talent and dedication to
practice it competently and compassionately. But premedical Students must be aware of some of the trends that appear to be
shaping the future of medicine. A number of programs win be held timing the year that are designed to inform our students
about such changes. Most of these programs are sponsored by Skull & Bones (S&B), the Premedical Society at Vanderbilt, and
they typically consist of a speaker who may be a physician or surgeon, a medical educator, or a medical student who win candidly
describe his/her profession and discuss its future. Such programs are supplemented by field trips to medical schools, and
community service events also sponsored by S&B. AU students are urged to attend such programs and participate in the
community service events.
Students who have doubts about whether or not they should continue in premedicine should keep their options open.
Medicine is not for everyone and there are few successful physicians who have not at times questioned whether or not the
rewards are worth the long years of training and the hard work required. Nevertheless, most physicians cannot imagine
themselves in any other profession and they would make the same choice again. The decision on whether or not to stay in
premedicine can be deferred quite easily through the first two years of college and perhaps through the third year without loss of
credit when changing to another major, for the suggested program through the first two or three years consists primarily of
courses that can be applied to almost any degree program in the College of Arts and Sciences. Indecision about a career is
usually corrected with time, if a real effort is made to learn more about the career. The people who most often feel trapped by
circumstances are those who have lost their ability to make logical choices because they made a premature commitment that is
not easily reversed. A major objective of the premedical advising program is to prevent this from happening to our students.
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THE HEALTH PROFESSIONS ADVISORY OFFICE AT VANDERBILT (HPAO)
Premedicine is not a degree program at Vanderbilt, but a preprofessional intention. The Health Professions Advising
Of lice will assist in a number of ways in planning for admission to medical school. Liaison is maintained with a number of
people and programs concerned with medical school admissions, including the Association of American Medical Colleges
(AAMC), the Medical College Admissions Test (MCAT) administrators, the American Medical College Application Service
(AMCAS), and close contact is maintained with the chairman of the admissions committee or admissions director of several
medical schools. This allows for the timely dissemination of information regarding changing policies or requirements for
admission. Various registration and application fomms are available from this office and assistance is available in preparation of
documents required in support of an application, including a composite evaluation. All serious premedical students are urged to
become familiar with the services available and to make full use of this assistance.
Periodic group meetings are held for students in premedicine, usually scheduled by class. Topics of interest to the
particular class are discussed and questions are answered in what are essentially group advising sessions. At the spring meeting
for Jimiors, application material is distributed and detailed instructions are given on completion of the application and the
necessary supporting documents including composite evaluations. Meeting information will be posted on the bulletin board
outside the HPAO and will be distributed by Shill & Bones Premedical Society. (See APPENDW IV)
All premedical students are urged to check the HPAO bulletin board at least once each week so that meetings of
importance and deadlines will not be missed. This bulletin board is the primary means by which commas cation is
maintained with premedical students.
The Health Professions Students with specific questions about any aspect of preparation for medical school including
course work the major, evaluations, preparation for the MCAT, where to apply, etc. are urged to make an appointment and come
by to discuss the problem. It is a good idea to periodically (at least once during the sophomore year and more often during the
junior year) stop by to review your record and make plans with the associate dean who coordinates advising in the prehealth
sciences. Appointments may be made by calling ~hmng office hours.
The Health Professions Advisor for Vanderbilt University is Dr. Thomas Oeltmann. His office is 2220 Stevenson Center
(Molecular Biology), (615) 322-2446. He and/or his secretary will be willing to help you in whatever ways that they can. The
Health Professions Advisory Committee consists of Drs. David McCauley (General Biology), Robert Roselli (Biomedical
Engineering), Amy Harshman-Green (Nursing), Akunuri Ramayya (Physics), Richard Larsen (Mathematics), Melvin Joesten
(Chemistry), Todd Graham (Molecular Biology), and Donald Sherbume (Philosophy), as well as Dr. Thus Oel~nn. The
function of this Committee is to assist in evaluating premedical and pre-dental students and in writing the recommendations for
them. It is in the name of this Committee that the official letter of recommendation from Vanderbilt University is sent to the
medical and dental schools. Committee members also stand ready to help in advising pre-professional students. A second Health
Professions Advisory Committee consisting of above faculty members, Dr. Deborah German (Associate Dean of the Vanderbilt
Medical School), and one or more students, determines the policy and practices of pre-professional advising and reports on its
functioning to the Dean of the College of Arts and Science.
In the Health Professions Advisor's Office, 2220 Stevenson, there are directories on the health professions, information
on careers and programs in the health professions, the official study guide for the MCAT, the foreign medical school catalogue,
the medical school curriculum directory, and an incomplete file of medical and dental school catalogues. Information on post-
baccalaureate and summer programs is also available. MCAT, DAT, AMCAS, AADSAS, and AACOMAS applications can be
obtained from this office.
In the second floor hall of the Molecular Biology lab building (near the Health Professions Office), there is a bulletin
board upon which items of interest to premedical, pre-dental, and other health-profession-oriented students are posted
Announcements such as dates of interviewing teams, test dates, availability of information on any new schools and programs,
special programs, summer employment, etc. will be posted there as it becomes available.
It should be stressed that the final responsibility for planning the academic program rests with the student and not with
an advisor. The advisor should explain the options, including requirements that must be met, but the final decisions as to which
courses to take and when to take them must be made by the student. Good judgment will be required, for there are many options
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available and many decisions to be made. The mature student will have as much information as possible on which to make any
decision. One of the best sources of information will be your fellow students, particularly those ahead of you who have already
taken the courses and who are acquainted with the instructors and course content. It is usually a mistake to register for a course
with no idea who will teach it and perhaps only a hazy idea of what is covered in the course. The better informed student will
usually be in a much more competitive position.
Additional Premedical Resources
ù In reference in the Science Library are the AAMC "Medical School Requirements, U.S. and Canada," the AADA
"Admission Requirements, U.S. and Canadian Dental Schools," the AAMC "AAMC Curriculum Directory" the AAMC
"The MCAT Student ManuaL" and other books about medical school admissions.
ù The Career Center (Office), 110 Alumni Hall, has an extensive collection of printed resources on health professions and up-
to~ate catalogues from all accredited schools of medicine, dentistry, public health, etc. Contact Mrs. Linda Bird for further
information and assistance. The Eskind Biomedical Library also has extensive information on medical schools.
ù ~ Skull ~ Bones, the Vanderbilt Premedical Society, is affiliated with AMSA-The American Medical Students
Association. Throughout the year, S&B offers many informative events, such as speakers who are physicians, in the effort of
preparing prehealth professions students for admissions and success in medical school and beyond. In addidan, S&B offers
many community service opport~mities. See APPENDIX 1V for further information.
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THE PREMEDICAL PROGRAMOFSTUDYAT VANDERBILT
When planning a program of study, students should keep in mind that they must usually meet three different sets of
requirements. First are the requirements of the medical school which must be completed before an applicant matriculates.
Second are the general degree requirements which are set by the faculty of the college for a particular degree. The third hst of
requirements are those set by the departmental faculty for the specific major. Planning must also include completion of the
subject matter which will be tested MU the MCAT before taking the test. Each of these specific requirements will be discussed
below.
Premedical Requirements
There are some variations between schools, but almost all of the U.S. medical schools will accept as minimum
preparation in science one year each of general chemistry, general physics, general biology and/or zoology, and organic
chemistry, all with the appropriate laboratory. Most also accept a quarter of biochemistry in lieu of the third quarter of organic.
Requirements for specific medical schools are found in Chapter 10 of the AAMC publication, MEDICAL SCHOOL
ADMISSION REQUIREMENTS. This booklet (henceforth referred to as MSAR) is an invaluable source of information and
every premedical student should be very familiar with this book' The latest edition of the MSAR should be consulted before
completion of the application so that you are assured of having all requirements for each school to which application is made.
Courses usually taken by our students to complete these requirements are charted in APPENDIX II.
Course Selection
When selecting courses pick those that will fulfill your distribution requirements for Vanderbilt University, count toward
your major or minor, andlor satisfy the admission requirements of medical or dental schools. These requirements show that at
least one year of biology, two years of chemistry, one year of physics, one year of English, and one year of mathematics are
necessary for admission to almost all medical schools. Check the MSAR directory early (or better stilt the catalogues of the
specific medical schools) to make sure that you select the necessary courses to fulfill the requirements for-admission to all-the
medical schools in your home state. The entrance requirements for 1994-95 for several schools to which many Vanderbilt
students apply are given on the next pages.
Students from Florida should take genetics (Molecular Biology 242) and statistics (Mathematics 180 or 233, Economics
201, or Psychology 210) for the University of South Florida. Students from Texas need two years of biology for the University of
Texas system medical schools and one year of biology (with lab) for Baylor. In addition to the courses that medical schools
require for admission, many schools recommend that students-take a variety of courses. Courses recommended by ten or more
schools are mathematics, biochemistry, humanities, physical chemistry, embryology, genetics, behavioral science, and social
science.
In selecting electives, a student should consider the following advice from the Catalog of Albany Medical College:
"Students are advised not to select courses, such as physiology and histology, which are subjects in the medical school
curriculum, to the exclusion of other subjects, such as embryology, which are not." On the other hand, note that biochemistry,
one of the most frequently recommended courses, is a part of the usual medical school first year curriculum.
The following table s~nmanzes the course requirements for admission to U. S. Medical Schools for 1996-97 as
indicated in the AAMC "Medical School Admission Requirements - 1996-97.11 In all cases, a one year course is required,
including the laboratory where applicable. The courses taken should be those regularly given for science majors, not courses
designed especially for premedical students, survey courses, or courses for non-science majors.
ù University of Arkansas, Illinois, Southern Illinois' and medical University of South Carolina do not specify any admission
requirements.
ù Many schools that require English courses for admission have stated that they would accept "W" courses of the CPLE.
Check with HPAO for information on particular schools.
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U.S. MEDICAL SCHOOL COURSE REQUIREMENTS -199~97
122 Medical Schools
Course Required # of Schools Requiring Vanderbilt Equivalent
Biology* 120BSCI 110a and 110b
(3 semesters are required by the
following: Baylor, UC Irvine, Chicago,
Hawaii, Iowa, New Jersey, Texas A&M,
Wayne State; 2 years - UCLA, Missouri
Nevada, Tex. Tech, U.Texas)
General (Inorganic) Chem 119Chemistry 102ab or
Chemistxy 103ab
Organic Chemistry 121Chemistry220ab
Physics 121Physics 117ab--118ab or
Physics 121ab-122ab
English 87Content not specified
Mathematics (unspecified) 49 Content not specified.
but since Physics requires
Calculus, premeds should
take Math 171ab, 172ab, or
173ab.
Calculus (specified) 22Mathemtics 171ab, 172ab,
or 173 ab
Social andlor Behavioral 14Content not specified
Science
lIumanities, social and 8Content not specified
behavioral science
(Nebraska,
St. Louis U. 12 furs.
Emory, Michigan,
Michigan State, Minnesota
18 hrs.; Johns Hopldus 24 furs)
Quantitative Analysis 5 Chemistry210
4Spanish 101-102 or others
Foreign Language
Cayman, Ponce, and
Puerto Rico require
2 years of Spanish
Genetics 2Molecular Biology 242-241
Statistics IMathematics 180, 233,
Econ. 220, or Psychology 210
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Additional Courses
Many of the courses listed in this section will be required m some of the majors listed above. Certain of these courses
should be taken by all premedical students unless special circumstances prevent their being scheduled. In this category are
Biochemistry, Genetics, and Microbiology.
Students should not attempt to take courses that comprise most of the first year of medical school daring the senior year
in college. Experience has shown however, that if a student has a strong background in sane of these courses, the first year of
medical school will be less stressful and the student will get off to a much better start. The desire to obtain a better background
for medical school must be tempered by the realization that the senior year of college will probably represent the last o~y
you will ever have to pursue academic interests in areas other than medicine. Many well qualified students take a few courses
completely unrelated to medicine or degree requirements during their senior year in order to indulge an interest in some area
which they have always wanted to pursue in more depth.
Selection of a Miser
Medical and dental schools would like to admit applicants possessing widely varying interests and with majors in
different fields. AU medical schools profess that applicants should have a "broad education," by which they mean:
(1) strong foundation in natural sciences biology, chemistry, mathematics, and physics.
(2) highly developed c~mnunication skills - the use and understanding of written and spoken language.
(3) a solid background in the social sciences and humanities.
Within this broad framework, a student is free to major in whatever subject or subjects he may find most interesting and
challenging and in which he performs best. The AAMC states, "It should be strongly emphasized that a science major is not a
prerequisite for medical school and students should not major in science simply because they believe this will increase their
chances for acceptance." The table on the next page lists the distribution by majors in undergraduate college for the medical
school class that entered in 1994-95.
The acceptance rate usually varies between 43% biomedical engineering and 71% molecular biology, for those majors
available at Vanderbilt, but most majors show an acceptance rate falling in the 35-45% range (nationwide). Majors which are
pre-professi~1 training in another health profession have a low acceptance rate for medical school (pharmacy 22%, medical
technology 22%, nursing 25%). Notice that there is no significant difference between the acceptance rate for students majoring
in the natural sciences (biology 35%, chemistry 42%, mathematics 40%, physics 44%), most social sciences (economics 49%,
history 52% political science 46%, sociology 37%), the humanities (Enghsh 47%, foreign language 44%, philosophy 48%), or
engineering (biomedical 48%, chemical 47%, electrical 38%).
These data verify the medical schools' claim that the discipline in which a student majors does not influence directly his
acceptance into medical school. Many medical schools urge students who major outside of the natural sciences to be sure to take
more than just the minimum number of science courses required for admissions. Notice, however, that 63% of all applicants
majored in the biological and physical sciences - 38% in biology, 11% in chemistry and biochemistry, 1% in mathematics, and
1% in physics, and the remainder in miscellaneous categories.
It should be emphasized that non-science majors, even more than science majors, need to do well in their science
courses. A chemistry major, for example, has ample opportunity to prove himself by performing well in upper-level chemistry
courses if he should make a C in General Chemistry, but such opportunities might be more difficult for a social science major to
find.
Dental schools similarly advocate that their applicants obtain a broach liberal education. One school of dentistry
recommends: "The prospective dental student is encouraged to take advantage of the oppornmities for a liberal education while
im college." Although data are not available on this subject, the applicant's undergraduate major probably does not influence his
chance of being admitted to a
The acceptance rate usually varies between 43% biomedical engineering and 71% molecular biology, for those majors
available at Vand~lt, but most majors show an acceptance rate falling in the 35-45% range (nationwide). Majors which are
pre-professional training in another health profession have a low acceptance rate for medical school (pharmacy 22%, medical
technology 22%, nursing 25%). Notice that there is no significant difference between the acceptance rate for students majoring
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in the natural sciences (biology 35%, chemistry 42%, mathematics 40%, physics 44%), most social sciences (economics 49%,
history 52% political science 46%, sociology 37%), the humanities (English 47%, foreign language 44%, philosophy 48%), or
engineering (biomedical 48%, chemical 47%, electrical 38%).
These data verify the medical schools' claim that the discipline in which a student majors does not influence directly his
acceptance into medical school. Many medical schools urge students who major outside of the natural sciences to be sure to take
more than just the minimum number of science courses required for admissions. Notice, however, that 63% of all applicants
majored in the biological and physical sciences - 38% im biology, 11% in chemistry and biochemistry, I % in mathematics, and
I % in physics, and the remainder in miscellaneous categories.
It should be emphasized that non-science majors, even more than science majors, need to do well in their science
courses. A chemistry major, for example, has ample opportunity to prove himself by performing well in upper-level chemistry
courses if he should make a C in General Chemistry, but such opportunities might be more difficult for a social science major to
find
Dental schools similarly advocate that their applicants obtain a broad, liberal education. One school of dentistry
recommends: "The prospective dental student is encouraged to take advantage of the opportunities for a liberal education while
in college." Although data are not available on this subject, the applicant's undergraduate major probably does not influence his
chance of being admitted to a dental school. Dental schools, like medical schools, prefer students who have taken more than the
bare minimum of required science courses
Vanderbilt University students have majored in a broad spectrum of disciplines and been accepted into medical and
dental schools. While most of the pre-medical students and pre-dental students major in biology, chemistry, or biomedical
engineering, majors such as mathematics, English, and psychology attract a considerable number of students. The table below
gives the majors of those students who entered medical and dental school in 1994 and the percentage of those students with each
major who were accepted. See chart below for acceptances of Vanderbilt applicants according to major.
MAJORS OF VANDERBILT PRE-MEDICAL AND PRE-DENTAL STUDENTS (1994)
Pre-Medical Pre Dental
Discipline No. MaiorinE % Accented No. Majoring Accepted
Biology 42 38 -
MoleclarBio. 24 71 1 100
Biomedical Engineer 21 43 1 100
Psychology 20 30 2 100
Chemistry 18 39
Double Science 16 56
Mathematics I 1 27
NeuroScience 7 57
English 6 33
Foreign 6 33
Philosophy 4 100
Engineer Sci 4 25
Anthropology 3 66
Chemical Engr 3
History 3 33
Physics 2 -
Classics 2 50
Political Sci 2 50
Nursing 2 50
Human Development 2 50
Economics 2
Sociology I
Music 1 100
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THE ADMISSIONS PROCESS
Factors in Medical School Selection
Medical schools utilize an adnussions committee appointed by the Dean of Medicine for selection of the entering class.
The size of the cmnmittee will vary from school to school but it will normally be composed of M.D.s from the clinical faculty,
Ph.D.s from the basic sciences faculty, and medical students who are typically in their third or fourth year. Some schools also
appoint alumni (practicing physicians) and most have some representation from the general public (consumer representatives).
Year-to-year changes in the composition of the committee at any particular school are often reflected in slightly different
emphasis on selection factors. However, all medical schools will select students to fill their entering class who show evidence of
high intellectual ability, a good record of accomplishments, and personal traits that indicate ability to Communicate with and
relate to patients in a realistic yet compassionate manner.
Admissions committees strive for objectivity in making their decisions regarding admissions. There is, therefore, a
great deal of emphasis on grades, scores on the MCAT, and other factors that can be easily measured, but they consider any
infonnation that is available regarding an applicant's overall suitability and promise as a physician. If such factors as state of
legal residence and other rather absolute factors are ignored (i.e., you comply with their particular requirements or preferences,
or you do not), there are four factors that will largely determine whether or not a particular applicant is accepted. These are: 1)
overall academic record, 2) scores on the MCAT, 3) evaluations from faculty members who have had the applicant in class and,
4) impressions made timing a personal interview with faculty and students of the medical school including members of the
admissions committee. Other factors that will affect the decision (but not generally equal in weight to the four listed above) are
work experience in a medical treatment facility and extracurricular activities. Each of these will be discussed below.
Overall Academic Record
The undergraduate record, particularly grades in biology, chemistry, physics and math (BCPM), is the most important
single factor in predicting whether or not a student will be admitted to a particular medical school. Most medical admissions
Committees feel that the quality of work in the subjects taken leading to the baccalaureate degree is the most important indicator
of probable success in medical school. The academic record may be viewed as including the cumulative GPA, subjects taken,
rigor of the major and trends in performance (i.e., were grades mediocre in the freshman year with a constant improvement
during the sophomore and junior years, vice versa, or was perfor nance relatively constant?). A strong undergraduate academic
record is considered evidence of both ability and motivation, hence, the heavy reliance by committees on this factor. Succinctly
stated, if a student has both high aptitude and good motivation, a competitive academic record will be maintained. Grades are not
evaluated alone but rather in the context of the total academic program with such factors as part time employment, participation
in varsity sports and other severe demands on study time looked upon as extenuating circumstances. The undergraduate
academic record should be stressed since it is difficult to compare records made in graduate or professional school or as an
irregular student taking carefully selected courses with those made by an undergraduate student in a regular degree program.
Quality Point Ratio
For most medical schools, the grade point average is the most important single criterion in determining whether or not a
given applicant is admitted. The table on page 10 gives the undergraduate grade point averages for 76 of the one-hundred-
twenty-f ve U. S. medical schools, for students who entered medical school in the falL 1994. The mean of these grade point
averages is 3.51.(AMCAS computation). Vanderbilt University Medical SchooL not listed in the table, had a mean
undergraduate grade point of about 3.6, while the University of Tennessee Medical Schools mean undergraduate grade point was
a 3.5. The table on page 11 hsts the AADSAS undergraduate grade point average for the students entering fifty dental schools in
the falL 1992. The mean GPA was 3.08. (Note that the University of Tennessee Dental School mean grade point average was
2.98.) Current dental figures not available.
According to the AAMC, "College grades are perhaps the most important single predictor of medical school
performance, although medical schools do recognize that grading policies may differ fmm one college to another, or even with
departments of the same institution. The mean undergraduate grade point average (GPA) of first year entrants dming the early
1980's was approximately 3.5 or a high B+. The C students admitted in recent years were usually individuals who either
achieved strikingly improved performances in their premedical studies after modest beginnings in their early years of college or
demonstrated other characteristics deemed desirable for medicine by the various medical school admission committees." It cannot
be too strongly emphasized that Vanderbilt students applying to medical and dental schools are much more apt to be accepted the
higher their quality point ratios.
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MEAN AMCAS UNDERGRADUATE GRADE POINT A VERA GE FOR THE CLASS
ENTERING MEDICAL SCHOOL DURING FALL, 199' 6
Mq3I52~iJ]2]2Qi _ MEAN GPA MEDICAL SCHDoL MEAN GPA
Alabama 3.5 Nkizn#;ka 3.64
AUIXI~Y 3.5 Nevada3.4
Arizona 3.5 UMDN] - N] Medical 3.35
AzioU`S3S 3.52 ULMDNJ - Robert Prod
Baylor 3.6 Johnson3.47
California, Uhiv.of New Mexico 3.4
Irvine 3.55 North Dakota 3.54
IosAngeles 3.57 Ohio, Med.oo11.of 3.28
San Die90 3.62 Ohio state 3.5
Son Eta l:~9co 3.71 CrJEdhl a 3.55
Chicago Medical 3.2 Oregon3.6
Chicago, Uhiv. of 3.5Pennsylvania Med.CO11 3.5
Cbnuxacticut 3.5 Pennsylvania State 3.5
0ornel1 3.53 Pennsylvania, Uhiv.of 3.6
Fort Carolina 3~35 Pit1sd~un~h 3.5
East Tesr~#3eae 3.4 Puerto Rico - Ponce 3.3
Eastern Virginia 3.32- Uhiv.oœ 3.5
Fmnry 3.62 - Bayamon 3.1
Florida, Uhiv. of 3.66St. Troic Uhiv. 3.62
GcsnnF4bown 3.51 South Alabama 3.6
George hb~lrl~gOon 3.4South Dakota 3.63
Hbo~n~nd 3.7 South Florida 3.7
Iowa 3.6 Southern c~lifo ~3.7
Kansas 3.5 Stanford 3.6
E~erbucky 3.44 Temple3.4
Tome Linda 3 59 Iere~#a3s 3.5
L9U/New Orl ~3.4 Texas A & M 3.63
LSU/9b4~'parb 3.4 lexas,Uhiv. Of
T^~;aville 3 5 Galveston 3.5
Ioyola 3.47 Houston3.41
Maryland 3.5 San Artonho 3.58
Nbs:#Kt~ueebOs 3.5 Uhifocasd SErvioes 3.4
byo 3.67 Vermont3.3
Misai 3.56 Virginia,Med.oDl.of 3.4
Michigan, Uhiv.of 3.6Virginha,Uhiv. of 3.56
}rota - Duluth 3.44 WbY~ublgOon - St. Tails 3.78
MI,o~ss~bs - MUl~#~polis 3.55Pb~ringbon~Uhiv.of 3.58
RMssiasippi 3.6Wayne State 3.5
Mauri - Col~mhiP 3.6West Virginia 3.55
Mount Sinai 3.5
MEAN rue ALL MEDICAL Signora IISTED AERATEÄ3.51
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MEAN AADSAS UNDERGRADUATE GRADE POINT A VERA GE FOR CLASS
ENTERING DENTAL SCHOOL DURING 1992-93
0~1 Scier~e Ov~1 scier~e
Dental School Mean GPa Mean GPA Dental School Mean GPA Mean GPA
A]k.~ees 3.31 3.14 HIln~3#ota 3.20 3.02
Baylor 3.04 2.91 }Ns~Y~'ri 3.123.05
Boston Shiv. 2.83 2.67 INtl~Y;ka 3.27 3.12
California New York Shiv. 2.85 2.78
7~= Angeles 3.3 3 3 North Carolina 3.16 3.11
San Francisoo 3.2S 3.13 Nkrtl~#sbarn 3.01 2.83
Case Win 2.69 2.51 Ohio State 3.08 2.90
001Orado 3.2 3.1 Oklahoma 3.032.94
ool~mhia 3.0 2.9 Oregon 3.303.2
Connecticut 3.1 3.0 Pacific,Uhiv.of 2.90 2.77
creightL^ ~2.96 2.75 Pennsylvania 3.07 2.95
Detroit 2.81 2.70 Pitild~m lo 2.98 2.81
Florida 3.02 2.91 Puerto Rico 3.37 3.23
Georgia,Med.CO1. 3.12 3.01 South Carolina 2.91 2.82
HE~nInd 3.35 3.26 Southern Calif. 3.3 3.21
Hc ward 2.74 2.50 Southern Ill.2.92 2.75
Illinois 3.91 2.75 SUNY-E uffalo3.02 2.91
Indiana 3.04 2.89 SUNY-Stcny Brook 3.22 3.14
Iowa 3.0 2.85 Temple 3.02.9
Rfs~ucKy 3.22 3.04 IesnY3~see 2.98 2.84
Era_ rinds 3.10 2.9 Texas, Uhiv.of
T^.KHana State 3.12 2.98 HkAE~on 2.99 2.87
~ ville 3.05 2.81 San Antonio 3.09 3.01
ME~l,'~bbe 2.76 2.55 Tufts 2.78 2.61
Maryland 2.97 2.85 Virginia,Med.Ool 3.08 3.04
Michigan 3.13 N.A. ~bc~hUngton,Uhiv.of 3.38 3.28
MEg.N ma. A;[L ~,L ùqt~mS T.TS71~ ,~ - E
0veral1 - 3.08 Science - 2.93
* Me da not hale c~anL figures on decked ~r~wYi~R.
ù Seventeen percent of Vanderbilt applicants with GPA's below 3.0 were accepted into medical school; however, most of those
accepted enhanced their records with one to three years of post-graduate work. The AAMC states, Mat nationally, I "Only
one percent of applicants accepted to the first-year class had GPAs of 2.5 or less."
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Advanced Placement
Advanced placement credit and/or exemption may be earned either by taking locally admimstered deparunental tests
(usually dunag summer orientation) or by participating in the Advanced Placement Program of the College Entrance
examination Board (CEEB). In the CEEB program college credit may be earned for advanced courses taken during high school
if the student scores sufficiently well on the CEEB advanced placement test. A student must exercise good judgment in
determining whether or not to accept this advanced placement if exemption is earned without credit. Whenever a premedical
student registers for a course, it should be with the reasonable expectation of making an A. A good source of information and
advice will usually be a fellow student who has already taken the course.
Some medical schools will not accept AP credit in those specific requirements for admission (biology, chemistry,
English, mathematics, and physics.) Should the student receive advanced placement in any of these subjects, he is strongly
advised to take an upper level course in that subject and to check the eatalogues of the individual medical schools. Vanderbilt
University does indicate on its transcripts how much AP credit was allowed and in which areas. Over 90% of the U.S. Medical
schools accept AP credits.
CLEP
The College Level Examination Program (CLEP) is designed primarily for nontraditional students, such as those who
have been out of school for several years. A student with good test taking skills may be able to exempt a course, but if the course
is needed as a prerequisite for some other college level course or is required for admission to medical sehooL it may be a mistake
to take the CLEP credit. A person exempting a course with CLEP credit may not have a sufficient background to do well in more
advanced courses in the subject or to score well in that subject on the MCAT. Most medical schools do not like the College Level
Examination Program(CLEP) and prefer that students not use it in courses required or recommended for admission. Many
medical and dental schools will not accept CLEP credit. Before a student undertakes any CLEP work, he should cheek with the
eatalogues of the individual medical schools to make sure that it will be accepted At least 75% of all medical schools accept
some CLEP credits.
Pass-Fail
Courses taken Pass-Fail are usually frowned upon by medical schools. Pass-Fail grades in courses required for
admission will not be accepted by most medical schools. A student who has too many hours of Pass-Fail credit on his transcript
is not looked upon favorably by medical schools. The rules of the College of Arts and Seienee and the Engineering SchooL and
about Pass-Fail credit ensure that Vanderbilt premedical and pre-dental students cannot take an excessive number of hours Pass-
Fail.
Low Grades
Grades of D earned in courses specifically required for medical or dental school admission will not be accepted. Such
courses must be repeated. Grades of D are not looked upon favorably in any course. Grades of C are acceptable and while they
are not very good, they should not, as a routine matter, be repeated. Should a C be earned in a required course, it is preferable to
take a different, higher-level course in that same diseipEne, rather than repeating the course itsehf.
Repeat Credit
Medical and dental schools are not happy with the student who has very much repeat credit on his . transcript. They
especially frown upon upperclassmen taking 100 level courses a second time. Should a student-find it necessary to repeat a
course, any grade lower than an A the second time around will be looked upon with great consternation. Surely, a student should
be able to get an A in a course on his second try! See above on the question of repeating courses where C's and D's were earned.
Note that AMCAS and many non-AMCAS medical schools average the grades when a course is repeated rather than
substituting the second grade, as the College of Arts and Science does.
Withdrawals
A sprinkling of W's (withdrawals) on a transcript is a cause for concern by most admissions Committees. One or two
W's will not usually adversely affect a person's chances for admission, but several, even with a good GPA, would be viewed very
apprehensively. Premedical students are therefore cautioned not to make a practice of withdrawing from courses. As a rule,
however, admissions committees feel that a student who makes a habit of dropping courses lacks either perseverance or a realistic
view of his own capabilities, or both. A series of W's will seriously weaken your record.
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Independent Study: Honors Program
Medical schools view independent study or participation in research or the Honors Program with great favor. The
AAMC states, "Students who have taken special honor courses or who have been selected for advanced sections of a regular
course should not hesitate to give medical schools detailed information about this. They also should request their college
advisors to refer to this in their recommendations."
Foreign Programs
Medical and dental schools have no objections to students participating in the Vanderbilt foreign programs.
Participation in these programs does not seem to influence an admissions decision one way or another. It should be pointed out,
however, that students who are abroad during the Spring semester will have to take the MCAT in London, Munich, Paris,
MadridL or another of the foreign test centers. Students planning to be abroad their senior year will have all medical school
interviews in September before leaving this country. If you plan to participate in a Vanderbilt abroad program be sure to notify
the Health Professions Office before you depart.
ROTC Courses
AMCAS and many non-AMCAS medical schools, as well as AADSAS and some non-AADSAS dental schools, do not
include grades in ROTC courses when computing an applicant's grade point average. Thus a student should not count on such
grades to improve his transcript.
College Attended
According to the AAMC, "Admissions committees know that academic standards vary fmrn college to college and that
criteria for grading may vary from department to department within the same institution. Through long experience, committees
realize that some high grades may be more difficult to attain than others. Some attempt, usually informal, is made to weigh the
grades from various colleges in order to be as fair as possible to all applicants."
The Medical College Admission Test
The Medical College Admission Test (MCAT) has traditionally been second in importance only to grades when
evaluating an applicant for medical school. Several AMCAS schools conduct a preliminary screening based entirely on GPA and
MCAT scores and secondary applications are not invited unless certain minimum scores are exceeded. Even if a secondary
application is accepted, most medical schools select applicants to be interviewed on the basis of combined GPA and MCAT
scores. The importance of MCAT scores can scarcely tee overemphasized.
The MCAT is given twice each year, in April and August. The latest that the MCAT may be taken is in August
approximately one year before an applicant expects to matriculate in medical school (i.e., applicants for the 1996 entering class
must take the MCAT, at the latest, d Ding the August administration of 1995). However, applicants are urged not to wait und1
the fall of the senior year to take the MCAT, but to take it in the spring almost 18 months before the expected time of
matriculation. If a student fails to score sufficiently well on the April test to be competitive, it is possible to retake the exam in
August and most medical schools will accept an otherwise well qualified student who has poor MCAT scores in the spring
administration of the test but good scores in August. The student who takes the MCAT for the first time in August as a rising
senior and makes scores that are not competitive (even because of factors such as illness, accident, etc., that are beyond his/her
control) will usually not be accepted the next year, causing a delay in entering medical school for a full year.
All applicants must present MCAT scores as a required part of the supporting material for their application at all but
two U.S. medical schools (Johns Hopkins and the University of Rochester). The test, which was significantly changed in form
for the 1991 a~ini~hon, is described in detail in the MCAT STUDENT MANUAL, a booklet published by the Association
of American Medical Colleges. This book also contains a separate practice MCAT. Students preparing to take the MCAT
should obtain a copy of this manual and carefully read the test description several weeks before the test. The MCAT now has four
sections, biological sciences, physical sciences, verbal reasoning and a writing sample. The AAMC feels that the new format
enhances the MCAT's predictive value and encourages students interested in medicine to pursue broad undergraduate study in
the social sciences and humanities as well as the traditional natural sciences. The science Sections will stress problem-solving,
but it will be necessary to know biology, chemistry and physics in order to arrive at the correct solutions. The verbal reasoning
section draws upon texts from the humanities, social sciences and natural sciences, but it will use them to test ability to
comprehend, reason and think critically rather than to assess expertise in these disciplines. The writing test Consists of two 30-
minute essays, neither of which will be scientific in orientation. There is a numerical grade fmTn one to fifteen, with eight as a
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mean assigned to the first three sections mentioned above, but a letter grade is assigned to the essay to discourage adding the four
tests to obtain n composite score.
There is considerable misinformation about the strategy which should be employed imtaking the MCAT. Many
premedical students have been advised to take the test '5u;st for practice" the first time, and then to come back and prepare for the
exam dming a second and perhaps third test. This is generally very poor advice. One reason is that it is not possible to suppress
the reporting of scores as was done several years ago. All applications will he accompanied by the results of the last two scores
made on the MCAT, and all other scores are available to medical schools.
Registration fonns for the MCAT may be obtained from the Health Professions Advismg Office or by writing MCAT
Program Office, P. 0. Box 4056, Iowa City, Iowa 52243. The registration material should be mailed well before the deadline, for
if there is a mix-up, such as failure to sign the application, failure to enclose the registration fee (which is $155 for 1995), OF
failure to provide a picture, the form will be returned. The regular deadline for registration is 30 days before the test. By paying
an extra fee (of $50) this may be extended for 15 days, but there are no provisions for taking the test as a '\Nalk-in" and a
complete registration form with a check or money order must be filed before a test admission ticket
Throughout the year, Shill & Bones offers on-campus diagnostic MCATs arranged through the Princeton Review and
Kaplan. Be on the lookout for information on the HPAO bulletin board or through Skull & Bones media.
For Information about MCAT preparation services in the Nashville area:
The Princeton Review Kaplan
contact person: Wade McKinneycontact person: Judy Damon
3508 Belmont Blvd. 3212 West End Ave.
Nashville, Tn. 37215 Suite 403 Westpark Building
phone: Nashville, Tn. 37203
phone: (615) 303-8638
Extracurricular Activities and Work Experience
"Admissions officers tend to beheve that efforts expended by a student in earning grades are reflected in the college
academic record." "Attention is given to extracurricular activities and part-time employment in interpreting the college
transcript." These two quotations from the AAMC indicate the role of extra curricular activities in the context of admission to
medical school. Given two students with identical grade point averages and MCAT scores, then extracurricular activities will be
a plus factor. At no time and under no circ~ances are extracurricular activities a substitute for good grades. The student who
becomes so involved in campus activities that his grades suffer is not likely to be admitted to medical or dental school. The
student who has good grades and participates in extravehicular activities wi11 undoubtedly be admitted before the one who does
not have such outside interests.
Involvement in extracurricular activities is viewed very favorably by admissions committees, for if a student can
maintain a competitive grade point average in a rigorous curriculum and still have the time and energy to actively participate in
extracurricular activities, both aptitude and motivation must be rather high. There is no particular benefit to the student who is a
"joiner" and who pays dues but never participates or becomes involved in an organization. A student who has been very involved
in activities that are people oriented, particularly someone who has held office in worthwhile organizations or who otherwise
presents evidence of leadership would be considered a strong candidate for medical school. Admissions Committees look for
people who are winners, for winging becomes a habit that will usually continue on through life. It must be emphasized, however,
that no amount of involvement in extracurricular activities can substitute for a good academic record and strong MCAT scores.
Such involvement is '`icing on the cake" for it will make an academically competitive applicant much more likely to be accepted,
but without good numbers to support the application, it may mean relatively little.
Medical-Related Work Experience
Work experience in a hospital, neighborhood health center or some other medical facility will also be viewed quite
favorably by most admissions committees. This is obviously not a prerequisite for admission, for only about half of the students
now admitted to medical school have any work experience, paid or as volunteers, in a medical treatment facility before they
matriculate in medical school. The primary value of working in a hospital, doctor's office, public health clinic, or nursing home
is to help in the decision of whether or not to pursue a career in medicine. The real value is to the student who can make a more
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realistic. It should be mentioned that a person who knows very little about the practice o medicine or has uoreahstic
expectations about a medical career will be viewed with considerable apprehension by an admissions committee, but there are
many ways this information may be gained besides carrying bedpans in a hospital.
Emergency Medical Technician (EMT)
Some students take training (such as the Emergency Medical Technician course) which allows them to obtain
employment in an emergency rwm, with an ambulance service, or in some other area as a regular or part-time paramedical
employee. The experience gained may be of considerable value if the work schedule does not cause grades to drop. As a general
rule premedical students are urged not to seek part-time employment during their first year but wait until a strong academic
record has been established if they must work. If grades begin to drop, the job may have to go. It is often better to work summers
or holidays so as not to interfere with classes and suffer a drop in GPA that may jeopardize acceptance.
Research Experience
Experience in scientific research is highly recommended by most admissions committees for the academically strong
student, especially if the results are published and/or used to w-rite an honors thesis. This type of experience is essential for a
person who aspires to a career in academic medicine/research but it is very useful for any premedical student. The problem need
not be in an area considered to be 'biomedical research" to be a valuable learning experience. There are many scientists at
Vanderbilt who are doing "biomedical" research, but there are many more who are working on problems in basic science, often
on the "cutting edge" that will give students an opporumity to learn how good science is done. One of the advantages in
attending a major research university, such as Vanderbilt, is to have the opporumity to participate in research as an
undergraduate and to see if you have the discipline and interest to develop into a research scientist. Many undergraduates
develop an interest in pursuing research as a career while participating in projects in the laboratory of a faculty member.
Volunteer Work
Obviously not every premedical student will be able to find a job that will give him/her a worthwhile experience in
medicine and help financially as well. Volunteer work is usually available around hospitals in many different departments.
Information on vohmteering may be obtained by contacting the Skull & Bones Community Service directors at Box 7098-B. A
short training period is an absolute requirement before a person may begin work and volunteers must present evidence of
immunization for measles, mumps and rubella plus results of a recent TB skin test. This will require some time before a person
may begin work, so contact the hospital several weeks before you expect to begin. Paying jobs unrelated to medicine may give an
applicant experience that will be beneficial when applying to medical school. Jobs that require considerable contact with the
public, such as in sales, offer excellent opportunities to develop better human relations skills. Some jobs teach a person
management skills and help the person to assume greater responsibility. Any "people oriented" work experience may be valuable
and will often be discussed in an interview.
The Evaluation
An important part of the documentation used to support an application for admission to medical school is the faculty
evaluation, often called a recommendation. At Vanderbilt, a composite evaluation for each applicant is prepared by the
Premedical advisor, Dr. Tom Oeltmann. In writing the evaluation, Dr. Oeltmann utilizes letters of evah~ation from upto four
faculty members solicited by the applicant with summary comments and ratings prepared by the chief health professions advisor.
To obtain a composite evaluation the applicant must distribute "Letter of Evaluation" fonns to selected faculty members,
then complete a "Premedical haformation Sheet." The Information Sheet is a legal document that requests the Health Professions
Advising Office to prepare a composite evaluation and submit it to the medical schools listed on the form. Since the composite
contains information protected by the Educational Rights and Privacy Act such as cumulative GPA and rank in class, it may be
sent only to those schools requested in writing by the student. These forms may be obtained from the HPAO. Distribution of
letters of evaluation may begin mid-way through the sophomore year (freshmen and first quarter sophomores are discouraged
fmm requesting evaluations). Upto four evaluations may be requested.
Medical admissions committees prefer a composite or committee evaluation to individual letters of recommendation and
many insist an such an evaluation if the applicant is in a program where such an evaluation is prepared. The reason for this
preference should be obvious upon a bit of reflection. The credibility of a consensus evaluation is much greater, particularly the
comments and ratings given by those who see the entire applicant pool and can make meaningful comparisons and ratings.
Premedical advisors are therefore in a good position to evaluate an applicant. They are also often known to the members of a
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medical admissions committee and if a good record can be established over the years of successfully predicting that certain
students with only marginal qualifications will do well in medical school their judlynent is trusted by the admissions
committee.
Once the premedical information sheet is completed and the requested letters of evaluation are on file, preparation of the
composite evaluation begins. The composite evaluation is completed by transferring all information contained in the letters of
evaluation to the composite evaluation form using a letter code to identify the instructor completing the individual evaluation.
Narrative comments, which comprise the most important part of the evaluation, are likewise transferred verbatim to the
composite form under a heading that identifies the instructor and his/her relationship to the student. The summary narrative
prepared by the premedical advisor will comment on the relative strengths and weaknesses of the student as compared to all other
students at Vanderbilt. Some of the biographical data fmm the information sheet will be imchlded in the composite evaluation.
In order for the composite to have good credibility, there should be no contradictions in the information included and the
information submitted by the student on the application. This is a primary reason considerable detail is requested on the
information sheet. It is to the advantage of most students to submit their information sheets and all letters of evaluation before
leaving the University for the summer since most composite evaluations are prepared during the summer. Those who wait until
late fall to complete their file will be at a disadvantage since the evaluation will arrive at the medical school late in the admission
cycle. This may result in a later interview and perhaps later acceptance than would otherwise be the case.
Buckley Amendment
An early decision that must be made is whether or not to waive right of access to the requested evaluation. Under the
provisions of the FaTnily Educational Rights and Privacy Act of 1974 (also known as the Buckley Amendment), students may
have access to their official records, which has been interpreted as including evaluations (but only after the student matriculates
at a medical school) unless they specifically waive this right. The applicant must be aware that a more candid, and therefore a
more helpful evaluation will usually be made if the professor knows that the confidentiality of the evah~ation is to be respected.
A waiver is found on the evaluation form and the appropriate box must be checked and the form signed by the applicant before
the evaluation letter is given to the evaluating instructor. By requesting the evaluation in person you may give the evaluating
professor additional information about yourself, answer questions, and renew acquaintances if it has been some time since you
have been in the instmctor's class. As a general rule it is best not to request evaluations from teaching assistants and temporary
instructors, for most have had relatively little experience in writing such evaluations. An experienced faculty member can very
often put a student's motivation and aptitude into excellent perspective with a few well-chosen words. The most important factor
in selecting an instructor who will be asked to prepare an evaluation, however, is that he/she should know you well enough to be
able to comment from personal knowledge on some fairly subjective factors such as motivation, interpersonal and communication
skills, compassion, and general character. A good evaluation will not be a rehash of grades made in courses, for such information
is already available in transcripts, but it will supplement the other information available and establish its own credibility based on
what is said in the narrative. The best evaluations usually have a good balance between instructors in the natural sciences and in
the humanities.
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THE APPLICA TION
Consider for a moment the problem facing the admissions commhtee of a medical school that recruits largely from the
national pool of applicants. There may be eight or ten thousand applications for perhaps 100 or 150 positions in the entering
class, and it will be possible to interview only a few hundred of these applicants. Most of the top-rated applicants will receive
multiple acceptances. How is it possible to interview the best of those students who may be most interested in your medical
school? How should grades and scores be balanced with other more subjectively evah~ated qualities such as personality,
motivation, leadership, etc.? It is not a simple problem, and committees have different methods of selecting those who will be
interviewed. The applicant must keep in mind that his/her fast, and in many cases only, contact with the medical admissions
committee will be thmugh the application. Since the first impression will be made by the application, it is essential that it be
carefully and thoughtfully prepared. An application containing smudges, erasures and strikeovers will not be very legible,
particularly after it has been photocopied, and may indicate a sloppy, careless applicant. A negative impression will also be
created by misspelled words, poor grammar, or a poorly organized personal comments section. Care must be exercised in both
form and content.
Where to APPb
'There are no bad U.S. medical schools" is a statement often heard. The accrediting agency for medical schools (The
Liaison Committee on Medical Education composed of representatives of both the AAMC and the AMA) ensures that every
medical school adheres to high standards in order to remain accredited. Furthermore, the USMLE is given to all medical
students and this has the effect of ensming that all medical schools cover certain fundamentals well in their curriculum. There
are, of course, strengths and weaknesses in individual medical schools and differences in the difficulty in obtaining admission to
different schools.
For most medical schools, the chances for admission are determined in large part by the applicant's state of legal
residence. This is true of both private and public schools. In all cases, state supported public medical schools give preferential
consideration to residents of their state. There is usually an upper limit imposed by legislation or admmi~ve edict on the
number of non-resident students accepted in a class in a state school. This is commonly ten percent but in a few public schools
no nonresident students are accepted. In many private medical schools, preferential consideration is given to residents of the
state for at least a portion of the class. Emory accepts Georgia residents to fill half of its class and Bowman Gray accepts half of
its entering class from residents of North Carolina. Baylor gives preferential consideration to Texans and Miami (a private
schools often enrolls about the same percentage of Florida residents as the University of Florida. Many other examples could be
cited, but complete information is available in the latest MSAR APPENDIX m lists all LCME accredited U.S. medical schools
with the number of applicants, size of entering class and percent in-state for the 1994 entering class.
State supported medical schools usually admit a few non-residents, but these will typically be people who have some ties
to the state andlor the school. The credentials of nonresidents are usually above the average for the class. A typical state
supported medical school may invite non-resident applicants for an interview only if they have a cumulative GPA of 3.6 or more
and scores of to or more on all areas of the MCAT. A new trend that appears to be gaining in popularity for public schools is to
require that non-residents apply on the Early Decision Program. If accepted, these applicants must matriculate. Such a policy
ensures that the only non-residents who apply have the medical school as their first choice.
A number of private medical schools recruit from the national pool of applicants. This includes many "prestige" schools such as
Vanderbilt, Duke, Johns Hopkins, Harvard, Washington University (St. Louis), and Yale. As might be expected, the credentials
of students accepted at these prestige schools are outstanding. All things considered, the chances for acceptances are lower for a
typical applicant at a school that recruits primarily from the national pool than at a medical school which gives preferential
consideration to students from their home state. This certainly does not mean that all the best students go to the prestige schools.
Many facts determine where a student will matriculate, particularly cost, and the qualifications of many classes in public medical
schools will be higher than in some private schools.
When deciding where to apply APPENDIX m should be read and the latest edition of MEDICAL SCHOOL
ADMISSION REQUIREMENTS should be carefully studied, especially the section on selection factors and the breakdown on
state of legal residence of the latest class. If you meet their requirements and appear to have a reasonable chance of acceptance,
you should then further investigate the school by reading the latest catalog or bulletin, which is available in the Health
Professions Advising Office. An application to an out-of-state medical school should be made if you have a particular interest in
some program at the school or some personal or professional preference for the school or the region of the country. The reason
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that a student applies to a school will be of more than passing interest to the admissions committee. If it appears to be a
"shotgun" application, made only in a desperate effort to be admitted anywhere with riffle knowledge of or interest in the school
the chances for a favorable decision are poor. The student who fails to apply to those schools at which he/she will receive
preferential consideration is being naive and perhaps foolhardy, no matter how strong the academic record or how much you
have dreamed of graduating from some particular prestige school. Competition is at an airtime high and in the titrated
medical schools high grades and MCAT scores alone are not sufficient to obtain an interview. They are looking for the student
who shows evidence of unusual promise as a physician. Unless an applicant has excelled academically and personally, it will be
very difficult to be admitted. APPENDIX IV charts Vanderbilt Applicants according to GPA and MCAT scores.
AMCAS
The American Medical College Application Service (AMCAS) is a centralized processing service for applicants to
participating U. S. medical schools. All applicants to AMCAS-participating schools must submit their application materials
through AMCAS. For the 1995 entering class, 111 of the 125 medical schools used the AMCAS service for application to their
entering class. There is a fee required for application through this service, which for the 1995 entering class was $50 for one
school $90 for two, $125 for three, etc. After the sigh school the fee is $10 per additional school. The fee for ten schools was
$240. AMCAS applications may be obtained from the Health Professions Advising Office, or by writing AMCAS, Association of
American Medical Colleges, 2450 N. Street, Suite 201, Washington, D.C. 20037-1131. Applications for schools not
participating in AMCAS may be obtained by writing directly to the admissions office of the medical school. Addresses may be
found in the MSAR
AMCAS, which is a~ninistered by the Association of American Medical Colleges (AAMC), provides detailed
admission information to medical schools and undergraduate premedical advisors in addition to its primary role of processing
applications. The advantage to the applicant of applying through AMCAS is that initially only one set of application matensi~
and official transcripts need be submit regardless of the number of AMCAS schools to which a student applies. Official
transcripts are required firm all colleges and universities attended. The transcripts should be sent approximately two weeks
before the AMCAS application is mailed. A transcript matching form, included with the AMCAS packet, is req!nred with the
transcript. Upon receipt of the application, AMCAS will perform an item-by-item check comparing all courses in the academic
record section of the application against the official transcript. Once all courses and grades are verified, the AMCAS application
is photocopied and sent to all schools designated on the AMCAS form. If you decide to apply to additional schools before the
application deadline, it is necessary to submit only an additional designation form with the appropriate fees, and all AMCAS
information will be sent to the designated schools.
A number of AMCAS schools conduct a preliminary evaluation (screening) of the application received from AMCAS,
and if the GPA and MCAT scores indicate that an applicant wiI1 not be competitive for admission to their particular medical
school a rejection is sent at this time. Medical schools require a secondary application, which will be mailed upon receipt of the
AMCAS application unless the student is rejected in the preliminary screening. Most schools require an additional application
fee which must be mailed to the school with the completed secondary application. There is usually a deadline on the filing of the
secondary application, usually two or three weeks, and this deadline should be carefully observed. Many state schools do not
require an additional fee, but the range for those charging a fee is fmm $10 to as much as $100, with $50 a typical amount for
private schools. It should be obvious that medical school application can be expensive if you apply to a large number of schools.
The greatest expense associated with the application, however, is usually for traveling to the interview and the other associated
costs such as meals, hotels, etc. These costs should be anticipated and budgeted for those who will be applying to several schools,
particularly if long distances for travel will be involved.
Some comments should be made about Page 2 of the AMCAS application, the section entitled "Personal Comments."
Many students apparently do not understand the purpose of this section, and it is sometimes left blank This will create a very
negative impression on the admissions committee, for the personal comments section is there to provide a space in which a
student may make a statement or bring information to the attention of the committee which would otherwise not be possible to
present. This is where an applicant's achievements may be called to the attention of the ca~unittee, where plans for the future
may be discussed, and where explanations may be given for performance which the applicant feels was not up to his/her
capability. Extenuating and mitigating circumstances may be outlined, but the personal comments section should not become an
apology for a poor academic record. Neither should it become a fantasy in Which a person plays out inflated dreams, but realistic
aspirations regarding a person's career may be spelled out.
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Admissions committees will be much more interested in achievements and accomplishments than in plans which may or
may not materialize. The talented, articulate student will find a way to list accomplishments in a way that is not boastful and
discuss plans that sound reasonable and sincere. A well-prepared personal comment will leave the reader with a sense of
having discovered qlute a lot about the applicant that was not known before reading this section. Some admissions committees
do not consider a student who has nothing to put in the personal comments section. It is recommended that the student carefully
compose the personal ccTnments, set it aside for a week or two, then come back and reread what was written. If it does not then
appear to say what was intended, it should be rewritten. The final version should be carefully checked for spelling, punctuation,
grammatical errors, and organization, preferably by someone with experience in editing. It should then be neatly typed by a
professional typist, leaving sufficient margins so that the material will photocopy well.
AMCAS Timetable
Many students wait until too late to apply, which can decrease their chances for admission As may be seen from the
discussion above, it takes several weeks from the time an application is mailed to AMCAS until a complete secondary application
is on file at the medical school admissions office. If documents are lost in the maiL transcripts are not sent promptly or any of a
dozen other things OCCUT, it can cause a delay in completing the application that can stretch into many weeks. The amount of
time reputed to complete a carefu11y prepared application is usually underestimated. The student who waits until the approach
of a deadline to start to prepare the application will have a decreased chance for admission. This is due both to the fact that a
hurriedly prepared application may not present the applicant in the best possible light and to the fact that a late application may
not receive the consideration from the committee that it would have if it had arrived earlier. Many students delay the MCAT
umtil August, or retake the MCAT in August with the expectation of applying to additional schools in case their scores improve.
The late arrival of an application makes it more difficulty to receive an interview, all other factors being equal.
Students should begin preparing their AMCAS application soon after spring grades are received. Official tIanscnpts
may be requested from the Registrar before leaving schwl for the summer with the stipulation that they are not to be mailed to
AMCAS until after spring grades are posted. The application can then be mailed by midsummer, allowing secondary
applications to be completed before resuming to schwl in the fall. Students enrolled im summer school should have their
applications essentially complete before summer grades are posted. Soon after these grades are reported, the application should
be completed and mailed. This timetable will usually allow the strong applicant to obtain an early interview and an early
acceptance.
Supporting Documents
It is the responsibility of the applicant to ensure that a complete folder is available to the admissions committee at each
school to which he/she applies. It is suggested that a separate folder be made for each medical school and as soon as the
secondary application is received from AMCAS schools, or the application itself fmm non-AMCAS schools, that a check sheet
be set up. Complete information regarding needed supporting documents will be provided by the medical school and these items
should be checked off as they are sent. It is wise to photocopy those documents which could be replaced only with difficulty.
Once a file is complete, most medical schools send an acknowledgment to the student. The kind of supporting documents
repoured will vary somewhat from school to school but in all cases evaluations (recommendations) are needed. These are usually
sent by the evaluator directly to the medical school. For some schools a composite evaluation will suffice, and further letters of
evaluation are actively discouraged. In most schools, however, an applicant is either rewired or allowed to submit perhaps two
or three additions personal letters of evaluation. Applicants are cautioned not to overwhelm a committee with a large number of
letters. Two or three additions letters from people who know an applicant well may strengthen the application if they can give
first-hand examples of the applicant's pleasing personality, general good character, and diligence. Ten or fiflceen such letters
may be viewed with considerably less appreciation by the committee members who must read them.
Lepers of recommendation from politicians or other public figures who know a student only slightly are usually a waste
of everyone's time, and in some cases can actually hmt rather than help an applicant if it is obvious that a staff person is writing
a perfunctory letter for the son or daughter of a constituent. This is not to say that letters should not be solicited from people who
know you well just because they may be rather prominent, for if they can co nment from first-hand knowledge, their evaluation
may have high credibility. A few medical schools utilize peer evaluations. They require a letter of evaluation from a fellow
student. Good judgment must be used in selecting the individual to do this evaluation, as is the case of all supporting evaluations.
Students should reline that admissions committees require a balanced evaluation that will realistically set forth an applicant's
strong and weak points if it is to be considered with high credibility.
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Applicants should send grade reports as they are received to all medical schools at which their application is pending.
Most schools require only a photocopy of the grade report. A final official copy of the transcript will be required after
acceptance, but before matriculation, that shows the degree awarded.
Finally, most medical schools require a recent picture (passport size) to accompany the application. Pictures are also
needed for MCAT registration and for the Premedical Information Sheet. In the interest of economy and convenience, it is
suggested that a good picture be made during the winter quarter of your junior year (preferably by a professional photographer)
and that a good supply be ordered in passport size (2"x2") so that they will be available without a lung wait or the extra expense
of having a rush order. Neat, conservative dress (coat and tie for men and a tailored suit or dress for women) will make an
applicant appear more mature and "professinna1." High school graduation pictures or candid snapshots at the beach, etc., do not
project the kind of image needed to support an application to medical school.
The l~terview
The recent large increase in the applicant pool has led to unprecedented numbers of applications at many medical
schools. Obtaining an interview has therefore become a major hurdle as several thousand applicants will have been narrowed to
a few hundred to be interviewed. Personal interviews are rewired at essentially all medical schools (the University of Iowa is an
exception). Interviews are granted only by invitation of the admissions committee and an applicant invited for an interview has
passed the preliTninaTy screening and is now being carefully considered for admission. The impressions made in a personal
interview will be extremely important, particularly for those students with grades and MCAT scores that are marginally
competitive. Many feel that it is impossible to prepare for an interview, but learning what to expect is a method of preparation.
The actual interview is conducted in different formats at different medical schools. Most schools utilize a "one-on-one"
personal interview with from one to as many as four or five different interviewers. Others use a "group interview." These two
different methods are illustrated by Medical College of Georgia, which utilizes a "one-on~ne" with two different interviewers,
and Emory University School of Medicine, which uses a group interview. At MCG, one interviewer will be a voting member of
the medical admissions committee, (possibly one of the student members) and the other will be a faculty volunteer who will not
have a vote on the committee, but who will prepare a smnmory of the interview with a rating which will become part of the
applicant's file. Personal Views are often quite unstructured, lasting from less than 30 minutes to more than an hour. Many
are like pleasant visits in which just about anything might be discussed. At Emory the interview is much more structured with a
group of three or more interviewers (usually consisting of a medical student, an associate member of the adm ssions committee
and chaired by a voting member of the admissions committee) who will interview three applicants.
Applicants must be prepared to answer some rather personal questions about their own backgrounds, beliefs, and
experiences, as well as some general moral and ethical questions. A good interview will determine what makes the applicant
"tick", how well he/she relates to others, and how well-informed he/she is on current events, particularly regarding events which
will have an impact on medicine and its practice. The practice of medicine demands that a person be articulate and have well-
developed interpersonal skills. Most experienced interviewers try not to place unnecessary stress on an applicant during the
interview, but on some occasions an interviewer win purposely ask questions or exhibit alludes designed to stress a student.
That is, some may use the "enco~mter session" format. A mature student win not become umduly flustered or antagonistic if
subjected to a stressful situation, but win remain composed and continue to answer questions in a candid and straight-forward
manner. Applicants should be aware that they may very wed obtain an excellent rating from a person who may act a bit hostile.
They may also have a poor rating from the 'friendly doctor" with whom they had such a pleasant visit.
ù Listed below are some of the things a person might do in preparation for the interview.
a)Review your record. Be prepared to answer questions regarding your grade point average, science average, MCAT
scores, grades on specific courses. Do not be surprised if you are asked about other medical schools to which you have
applied.
b)Know who submitted your letters of evaluation and be able to answer simple questions regarding their field, where they
were trained) etc.
c)Have some familiarity with the medical school before the interview. Some applicants appear naive or very u formed
about a school to which they have applied. You should have some idea of the opportunities for research, or innovative
programs for the institution. This information maybe gained in a short conversation with a friend who is currently
enrolled, or it may be obtained from the MSAR plus the catalog. The current catalogs of about half of the 125 U.S.
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medical schools are available in the Health Professions Advising Office. The interview usually offers an opportunity for
the applicant to ask questions and obtam additional information about programs of special interest.
ù Listed below are a few statements/questions that are often used Bring interview.
a)Tell me about yourself. This is one of the most commonly used ways to begin an interview. Many interviewers will ask
that you continue if you are too brief. Be prepared to give more detailed explanations until the interviewer is satisfied.
They often ask about your family and the kind of relatiQnabip you have with family members. This type of open-ended
format gives you an opportunity to describe accomplishments while giving background information. An applicant
should not soumd boastfi~1 but '`if you've done it, it ain't bragging" is an old aphorism. The interview gives you the
opportunity to make the committee aware of positive things about you that would be difficult to present in any other
way.
b)What do you expect to be doimg 10 (or perhaps 15) years from now? This gives the applicant an opportunity to discuss
not only medical specialties that are of interest but preferences as to the type practice, where you prefer to live (city vs
small town, region of the country, etc.), other plans plus any concerns that are important to you.
c)............................................Why do you want to be a physician? This may be asked as or followed up with when and how did you first become
..............................................interested in medicine? Do you have any work experience in a medical setting?
d)............................................What do you do for enjoyment? This may include such questions as what do you like to read, or what were the last
three books you read? How do you stay physically fit? What are your hobbies, what sports do you enjoy, or what
extracurricular activities do you participate in?
e)What are your plans if you are not accepted to enter medical school?
f)Are you more interested in a clinical practice or research? Have you had any research experience? If the answer is yes,
you will usually be asked to discuss the research in some detail.
Why did you apply to this particular medical school? Where else have you applied/been interviewed/been accepted?
Which school is your first choice?
h) How do you plan to finance your medical education?
i)Are there any physicians in your immediate family? Are there any close friends who are physicians.
j)Why did you attend your particular undergraduate institution? Why did you choose your particular major? Do you feel
that you obtained a good education there? Why or why not?
Some medical schools invite an applicant to be interviewed by a regional representative if the school is a long distance
from both the applicant's undergraduate school and home. The regional representative is usually an experienced physician who
is a graduate of the medical school and he/she will typically have had considerable experience in interviewing, open as a former
member of the admissions committee. The interview will usually be held in the doctor's office. The purpose of this type
interview is merely to save the applicant the expense of traveling a great distance to interview at the medical school. The obvious
disadvantage is that the applicant will not see the facilities of the medical school and the interview is usually with only one
person.
An applicant who has received an invitation at a medical school a long distance from both home and school and who
has applications pending at other medical schools in the area can often arrange to have an interview while on the same trip. For
example, if a student has received an invitation to interview on the west coast, it is of ten possible to arrange an interview with
one or more other medical schools at which an application is pending during the same trip, saving several hundred dollars in
airfare. Not all schools will be able to accommodate applicants in this manner and sufficient time must be available to juggle
schedules, but a long-distance call to the admissions office of other schools in the area to inquire if an interview might be
forthcoming involves little outlay and it may save a great deal of money.
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FINANCING A MEDICAL EDUCATION
The cost of a medical education has dramatically increased since the mid- 1970's, making it increasingly important that
premedical students carefully consider how they will pay medical school tuition and fees, books and other educational expenses
plus living costs. The rapidly escalating costs are due both to large increases in tuition at most medical schools and to the
general increase in cost of living that has pushed up costs for everyone. At private medical schools the average yearly cost for
tuition and fees was $21,887 for the 1993 entering class. At public schools average tuition costs were $8,221 for residents of the
state and $18,178 for non-residents. Other living expenses will very widely depending on the particular city and lifestyle, marital
status, etc., but $10,000 or more is common for single students. Married students with children find living costs particularly
difficult to meet with perhaps only a spouse's income and much of it absorbed in child care costs. Most medical students find it
impossible to work part-time while in medical school. Many of the programs used to finance educational costs for medical
students through the 1980's have been cut in the past few years as tuition and living costs have continued to rise.
A number of financial aid programs were initiated by Congress during the middle to late 1960's that were designed to
increase enrollment m medical schools and at the same time increase the accessibility of a medical education to students for
whom medical school admission had been very difficult if not impossible. This group includes the traditional racial and ethnic
minorities that are underrepresented in medicine, females, and the economically and socially disadvantaged. A great deal of
federal money was appropriated to build new facilities at medical schools and to provide capitation funds that were awarded to
the schools with the stipulation that enrollment must be increased. Several new medical schools were built during this time and a
number of scholarship programs, low interest guaranteed loans, and other financial aid programs earmarked specifically for
students in the health professions were initiated. In 1969, first-year enrollment in U.S. medical schools was just under 10,000.
The success of these programs is seen by the fact that by the early- 1980's, first-year enrollment went above 16,500.
Medical schools recognize that most students will not be able to pay for their medical education completely from family
financial resources. Every medical school has a Student Financial Aid Office that will assist accepted students to arrange a
financial aid package if such help is needed. About 80 percent of the students currently enrolled in U.S. medical schools receive
some form of financial aid, most of it in the form of loans. Students applying for need-based financial aid are required to submit
detailed financial infonnation about income and assets for both themselves and their parents to a national needs analysis service
such as the Graduate and Professional School Financial Aid Service (GAPSFAS) or the College Scholarship Service (CSS). This
information is analyzed and the service will report an expected "student and family contributiam" Each medical school also
develops an annual student budget which sets forth detailed educational and living expenses. The "student and family
contribution" is subtracted from the school-approved student budget to determine financial need. The actual financial aid
package may consist of various types of aid from several different sources. This financial aid process is complex because of the
different sources from which aid may be obtained and the differing requirements and application procedures for each source. It is
essential that students who will require financial aid contact the financial aid officer at the medical schools to which they have
applied and file the necessary forms well before any deadline. Aid is not awarded until a student has been accepted for
admission, but it is not necessary or desirable to wait until after an acceptance is received to apply. An application for financial
aid should be filed with the Student Financial Aid Office in January or early February at most medical schools. Students
applying in April may find that most of the less expensive loan fimds are committed.
National Hdalth Service Corp Scholarships, a service commitment program, was utilized by many students timing the
1970s and early 1980s, but this program has been drastically reduced. One or two scholarships are now being awarded each year
at most medical schools and these go to students with exceptional financial need. There has been some discussion in Congress of
increasing the number of these scholarships.
Most private medical schools have scholarships, fellowships, and grants from their endowments OI from special funds
donated to the school by alumni, friends, private companies and philanthropies that are available for talented students accepted to
enter their program. Some of these will largely overcome the difference in tuition costs between private and public medical
schools. Such scholarships should be carefully investigated by students with strong academic credentials before arbitrarily
deciding to attend a state school because of reduced cost when a particular private school is preferred. A few scholarships, such
as the Woodruff Fellowship in Medicine at Emory University and the Justin Potter Scholarship at Vanderbilt University, pay full
tuition and an allowance for books and other academic costs. There is no payback provision to such scholarships and recipients
have no other obligations that would in any way restrict their future career development. Public medical schools usually award
only a few merit scholarships, and the stipend is usually low compared to many private school scholarships.
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Loms are the primary means of supplementing family and student contributions for most medical students. Many
medical schools have institutional funds that are loaned on a revolving basis (i.e., fimds are replenished as old loans are repaid).
Some of these are at very reasonable interest rates. Loans that are available to both undergraduates and professional students
have strict limits on the total amount that may be borrowed. Premedical students should be very cautious about assuming large
debts umder these programs while undergraduates, otherwise they may not be able to qualify later for such loans while m medical
school. The best loans to obtain are obviously those that have low interest rates, that are subsidized (the federal government pays
the interest while the student is in medical school) and have repayment provisions that are flexible. The federal loan programs
that have these characteristics are all based on financial need determined as discussed above. Perkins Loans (formerly called
National Direct Student Loans) and Subsidized Stafford Loans (formerly ~n~ Student Loans) both have no interest
accumu1`wion while in medical school or while the loan is in deferment. There are strict limits as to the amount that can be
borrowed umder these terms.
The federally insured loans that are cost-based (a term used for those that are not need based) are the Federal
Unsubsidized Stafford Loan and the Health Education Assistance Loan (HEAL). These are much easier to obtain but the
interest rate is considerably higher. HEAL loans have a variable interest rate, based on the rate for 91 Way Treasury Bills plus 3
percent, which recently put the rate above nine percent. Interest accrues fmm the day the loans are made and there is also an
"origination fee" of 8 percent (this fee includes insurance for the lender plus various commissions) that is charged in advance
(the premium is deducted from the amount disbursed, i.e., you sign a note for $10,000 and receive $9,200). Many consider the
HEAL a loan of last resort.
A new subsidized federal loan that has a fairly low interest rate of 5% is the Primary Care Loan. These loans are
available to medical students who pledge to go into the "generalists" specialties, which include family medicine, general internal
medicine, and general pediatrics. If a person receiving such loans decides later to go into a different specialty, there is a rather
severe financial penalty. Since most students change their mind about their specialty on average more than three times from the
time they enter medical school until they begin their residency training, this loan should be accepted only if a student is
absolutely certain of their choice, and for most students this is not possible to determine until they complete their clinical
clerkships during the junior year.
The AAMC in 1986 developed a comprehensive loan program called MEDLOANS exclusively for students enrolled in
LCME-approved medical schools (all U.S. medical schools are accredited by the LCME). This was done largely in response to
concerns that other sources of fimds would not be available to medical students and that increased default rates by borrowers from
other health professions would push the insurance premium for HEAL and other such loans to unacceptably high rates. One loan
available under MEDLOANS is called Alternative Loan Program (ALP). This loan has rates similar to those of the HEAL
program, but no need-analysis is required. ALP and HEAL loans have no provision for the government to pay interest while the
student is in medical school or in intern/residency programs as is the case with some of the other loans which are need-based.
The interest may accrue while the borrower is in school to be capitalized later, but this is an expensive option. Students must be
aware that it is difficult to manage a large debt during specialty training and career choices may often be dictated by the need for
money when a large educational debt is assumed. Some parents co-sign an educational loan for their children and pay the
interest on the loan while the daughter or son is in medical school. This is an excellent way for parents to provide financial
assistance and avoid the compo~mding effect of loans for which the interest accrued during medical school is "capitalized" upon
graduation, adding greatly to the size of the debt. At one time this interest could be a tax deduction for the parent, but this
should be checked by a tax attorney due to changes in the 1986 tax reform act.
It must be kept in mind that the primary responsibility for meeting the cost of a medical education rests with the medical
student. Medical schools consider family resources as the first form of financing upon which medical students must draw. The
AAMC conducts an annual survey of students graduating fmm medical school that includes information on indebtedness. For
the 1994 graduating class the median debt incurred was $53,000 and $77,000 for graduates of public and private medical schools
respectively and 80 percent had loans. Predictions are that this figure will continue to increase. Students must be
psychologically prepared to assume debts amounting to many thousands of dollars if they expect to pay a major portion of the
cost of their medical education through loans.
One possibility for financing a medical education for those unable or unwilling to accept a scholarship that involves a
service commitment or who are unable to qualify for need-based loans is to borrow the money from family members or friends as
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a regular business arrangement. Promissory notes may be prepared with each note bearing its own interest. Such interest rates
could be lower than HEAL, ALP or other market-rate loans, but could still yield a rate of return to the lender better than a
savings or CD. Students in medical school should realize that they are a good risk and that they will be able to repay the
loan fmm future earnings. It should be pointed out that residents are paid by the employing hospital as a house staff member. In
1993 first year house staff averaged almost $30,000 and by the fiflh year this went to almost $36,00. Most residents can live on
their salary as a house officer and begin to repay some of their loans.
The future availability of scholarships, grants and low interest loans to medical students from modest financial
circumstances is not assured. For the past 30 years or so most medical schools could truthfully state that any student with the
necessary academic and personal qualifications for admission would not be prevented fmm graduating because of financial need.
At the present time, the situation regarding financial aid is so unsettled that it is not clear whether or not this statement will
continue to be made. Chapter 7 of MSAR contains much useful information about financing a medical education. The most
recent MSAR should be consulted as a starting place for information on financial aid in medical school and the AAMC booklet
"Financial Planning and Management Manual for U.S. Medical Students" is an excellent resource that is highly recommended
(see order information in Appendix A). However, the student financial aid office at the medical school at which you have been
accepted is the source for the latest information and will in most cases be of the greatest assistance. The financial aid office has
the responsibility for 'sting together" a package that will allow students accepted at their institution to pay for their medical
education.
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IF YOU ARE NOT SELECTED
Most premedical advisors agree that one of the most difficult tasks connected with their job is counseling the rejected
applicant. The unsuccessful applicant is usually depressed and often a bit hostile to the advisor and to the system that seems to
have caused the rejection. Many rejected applicants are unable or unwilling to see themselves in true perspective, yet one of the
first things rejected applicants should do is to honestly and realistically assess their position and identify the reasons for the
rejections. In the vast majority of cases this is simply a matter of statistics. Their grade point averages and/or MCAT scores are
typically well below the mean for accepted students. There are three courses of action open to the rejected student. These
include 1) reapplication 2) matriculation at a foreign medical school or 3) choose some alternative career. Each of these is
discussed below.
Reapplication
For the past five admission cycles the number of applicants has significantly increased each year with a predictable
increase in the credentials of accepted students. Average GPA and MCAT scores are at an all-time high and many talented
students are not gaining admission. In this environment if a rejected applicant reapplies with essentially the same credences,
the chances for a favorable decision are slight.
Rejected applicants should arrange a conference with someone on the medical admissions committee at a school to
which they have applied and/or seek advice froth their premedical advisor. The purpose of this meeting should be to identify
those areas in which their application appears to be deficient and then devise realistic ways in which deficiencies may be
improved. The rejected applicant must be very realistic when evaluating the chances for significantly improving the deficiencies
in their application. In some cases this may mean simply retaking the MCAT with better preparation and an improvement in the
scores. In many instances the GPA must be improved. A low GPA can be improved only by taking additional classes and
making better grades in them. The overall GPA may be quite competitive but grades on the required biology, chemistry, and
physics may be low. This indicates a poor aptitude for science, which is a serious deficiency as viewed by most medical
admissions committees. If a student continues to take science courses and continues to turn in a mediocre performance, this will
not correct the deficiency. Medical admissions committees are usually much more impressed by high aptitude than by an
adequate proficiency that has been painstakingly acquired over a period of several years. A person may take additional course
work as an irregular postbaccalaureate student after completion of the baccalaureate or go to graduate school. Students choosing
this latter option should be aware of the fact that medical admissions committees are increasingly reluctant to accept a person
who is enrolled in a graduate degree progra n before he/she has completed a degree. Most M.S. programs in the sciences require
a full two years for completion. This means that a person choosing to enter a masters degree program immediately after
receiving a B.S. should consider reapplication the second year after the baccalaureate when the M.S. would normally be awarded
before matriculation in medical school. Completion of the M.S. in some basic science with a strong academic record should
considerably improve the chances of a candidate who was marginally competitive as an undergraduate. There are, of course, no
guarantees that this strategy will be successful. A person enrolling in graduate school should therefore do so in a discipline
which he/she would consider pursuing as an alternative career.
Foreign Medical Schools
Large numbers of U. S. citizens who could not gain admission to American medical schools attended foreign medical
schools in the 1970s and early 1980s and many of these Foreign Medical Graduates (FMGS) are now practicing in the U.S.
There was a decrease in the number of Americans going to foreign medical schools in the late 1980s as the applicant pools
decreased, but with the increases that began in 1990, the numbers are up again. In order for foreign medical graduates to be
licensed in the U. S. they must pass the appropriate examinations and complete an approved residency in an American teaching
hospital. There has been considerable discussion about decreasing the number of U. S. residency positions to just over the
number needed to accommodate U. S. medical school graduates, which would have the effect of keeping most FMGs from
practicing in the U. S. This possibility makes graduating from a foreign medical school a much less attractive alternative now
than a few years ago. Persons seriously considering enrollment in a foreign medical school must be aware of some of the
difficulties that they will face. Older copies of the MSAR contained a discussion of foreign medical schools as an alternative for
U.S. citizens, plus an excellent reading lisp but this section was eliminated in the 1994 edition. For those students who are
seriously considering this alternative, it may be wise to obtain a copy of the 1993 MSAR and read this information.
It is virtually impossible for rejected U.S. students to be admitted to a medical school in Canada, England or Australia.
If a person plans to enroll in a foreign medical school that is well established, it will usually be one where a language other than
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English is used imclasses and clinics and where the student must live in a foreign culture, often in a thirdworld country. A
number of medical schools were established in the Caribbean dming the 1970's which cater primarily to Americans and in most
cases the language of instruction is English. These are usually proprietary and they are in the "business" of medical education to
make a profit. There have been some sudden, unannounced closing of these schools, sometimes at mid-teIm and no rebates were
made for fees that were prepaid. Tuition for most such schools is high and in most cases clinical facilities are very primitive.
They manage to make a profit on the several thousand dollars per term in tuition and fees charged which is in sharp contrast to
U.S. medical schools. Tuition and fees cover only a part of the actual costs for a medical education for accredited U. S. medical
schools. Some years ago it was estimated that it costs an average of more than $40,000 per year per medical student.
Medical school is a very taxing and stressful experience for most individuals even under the best of circumstances, but
the difficulties are compounded when lectures and examinations are given in a foreign language and a person must cope with
living in a foreign culture. It should not be surprising that a large number of the American students enrolled in foreign medical
schools drop out before completion of the M.D. degree, often after having spent many thousands of dollars on their medical
education. Many of the proprietary medical schools have virtually open admissions policies, and they will accept essentially all
the applicants who can afford to pay the tuition.
Transfer to a U.S. medical school with advanced standing is by far the preferred route for a U.S. citizen enrolled in a
foreign medical school. Most U.S. students enroll in a foreign medical school with the expectation of transferring back to a U.S.
medical school after completing their basic medical sciences (usually after two years), but the opportunities for transfer are few.
It has been estimated that less than five percent of the U.S. citizens enrolled in foreign medical schools are accepted in U.S.
medical schools 'Nvith advanced standing" (transfer) and most of these have come from a very few schools that have maintained
reasonable standards in both their admissions policies and in the courses offered in the basic medical sciences. The most
important factor in achieving "admission with advanced standing" has been the overall score on the Medical Science Knowledge
Profile (MSKP) test. This is a test similar to Part I of the National Boards, but reputed to be more difficult. Students with good
test-taking skills, as shown by high MCAT scores, will usually have an advantage on the MSKP. Conversely, students with low
MCAT scores, even after two or three repeats of the test, would not be considered good risks for transfer. Recent policy changes
allow foreign medical students to take Part I, USMLE exams, which is used to evaluate students applying for transfer from a
foreign . medical school.
The most common option available to U.S. students enrolled in a foreign medical school is to graduate. This of
requires more than the four years usually required at U.S. schools. A person awarded the M.D. by a foreign medical school may
then take an exam administered by the Educational Commission for Foreign Medical Graduates (ECFMG). A new exam called
Foreign Medical Graduates Examination in Medical Sciences (FMGEMS) has now replaced the old ECFMG exam. If this
examination is passed, a person is eligible for approved internships and residences in this country. Fewer than one-fourth of the
U.S. citizens who take this exam usually pass, and the number of residency slots for foreign medical graduates has rapidly
decreased over the past few years. Graduates of foreign medical schools cannot be licensed to practice in the U.S. unless they
have taken an approved residency program in a U.S. hospital. A person may have the M.D. degree but skill not be able to
practice medicine in the U.S., and this is becoming a fairly common occurrence. The AMA has taken the position that U.S.
citizens who are FMGs should be allowed to enter U.S. residencies only in exceptional circumstances. There is concern that
most such positions in the U.S. may be phased out.
There is another alternative called the "fifth pathway" in which a student may complete the academic courses in medical
school in a foreign coumtry then return to the U.S. for one year of clinical training supervised by a U.S. medical school rather
than fulfilling the social service requirements for the M.D. degree in the foreign country. This process has been utilized chiefly
by students in Mexican medical schools. Filth pathway students complete an approved iTHemship or residency and may then be
licensed to practice medicine in most states, but again there is a possibility such programs will be phased out.
From this abbreviated discussion it may be seen that U.S. students enrolled in a foreign medical school may encounter
great difficulty and much uncertainty. With the recent large increases in number of applicants to medical school, there are many
talented students who are not accepted. This has caused a recent increase in the number of U.S. citizens matriculating at off-
shore medical schools.
The worst possible way to choose a foreign medical school is to answer ads in U.S. newspapers. Those foreign medical
schools for whom there have been the greatest number of complaints regularly place advertisements in U.S. student newspapers
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and large metropolitan papers (particularly Sunday editions) in which they make exaggerated claims regarding their status and
imply recognition by certain official U.S. agencies because U.S. citizens are eligible for certain types of loans. Eligibility for
federally guaranteed student loans from private lenders does not constitute evidence of approval of the quality of the school.
Placement agencies and clearinghouses also advertise in U.S. newspapers with claims of being able to help students obtain
admission to foreign medical schools, usually for fees of several humdred (sometimes a few thousand) dollars. Most of the
information and many of the services provided are available at no cost or at a very nominal cost from premedical advisors, the
AAMC, foreign consulates, and a number of other agencies. Students should be particularly cautious about signing contracts for
such services. The AAMC warned in the 1993 MSAR '`the opporOmities for U.S. citizens to obtain a quality medical education
abroad are very restrictive and the possibility of being exploited by schools catering to the U.S. student market is great."
Career Alternatives
For the rejected applicant with both grades and MCAT scores well below the mean for accepted students, the reality of
the situation may dictate that some alternative career be chosen and plans for a career as a M.D. be abandoned. Osteopathic
medicine awards a D.O. and practitioners have essentially the same rights as a M.D., yet GPAs and MCATs on average are
lower. A pediatric physician earns the D.P.M. and is more restricted in practice than the M.D. (they operate only on the feet and
lower legs), but this is a growing field and many students find satisfying careers in this closely-related field. Students may wish
to consider other careers in the health sciences, although some of the professional schools listed below may have a bias against
rejected premedical students if they feel that the applicant is attempting to use their profession as a stepping stone into medicine.
Other closely related careers include dentistry, veterinary medicine, optometry, and pharmacy. Many former premedical stnfl~nts
complete a Ph.D. in some discipline in the basic medical sciences and enjoy a very satisfying career in teaching and research,
oRen at a medical school Others take graduate degrees in public heath, clinical psychology, or one of the allied health sciences,
such as medical technology or clinical chemistry. There are numerous career opporhmities in these areas. Hospital
adminisuahon should be considered by those students with good management skills and the ability to work well with people. It
must be added that most of these professions are highly competitive and no assurance can be given that a student applying for
graduate or professional school in these disciplines will be accepted. There are, however, many talented students with much to
offer professionally who are not being accepted for admission to medical school.
Many rejected premedical students prefer to go into other professions which are completely unrelated to the health
sciences. Unless a person can be reasonably assured of a satisfying and successful career in some other area of the health
sciences it may be a mistake to remain in a job in which the opportunity for professional advancement is listed just in order to
stay in a medically related profession. Students leaving the health care field freely find very satisfying careers in such
diverse fields as banking, law, sales, military service, and dozens of other businesses and professions. Whatever alternative
career is chosen, it should be one that is intellectually stimulating and it should offer rewards commensurate with the talents of
the student.
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MEDICAL SCHOOL POLICIES AND SPECIAL PROGRAMS
U.S. medical schools offer a number of innovative programs designed to assist students with special problems or
particular needs. It is beyond the scope of these guidelines to discuss these programs in detail or to list the schools offering them.
However, some introductory information on certain of these programs may be beneficial to the student who is totally uninformed
about such programs but may have interest in a joint degree or a reason to use some of the services offerecL A starting place for
information regarding any of these programs is the latest edition of the MEDICAL SCHOOL ADMISSION REQUIREMENTS.
Further information will be available from the medical school catalog. Some of the more popular programs and policies are
outlined below.
Early Acceptance Program at Vanderbilt
In the spring of the sophomore year, Vanderbilt students may apply for early acceptance into the Vanderbilt School of
Medicine. Applicant must have a minimmn GPAof 3.5 and complete a special application obtainable at 403 Light Hall. The
applicant must also request letters of evaluation following the aforementioned guidelines. In most cases, an interview is
conducted by members of the Medical School Admissions Committee.
If granted early acceptance, the student is assured a place in the first year class following his graduation. In which case,
the MCAT is optional. Usually about 15-18 Vanderbilt Undergraduates are accepted into this highly selective program. However,
it should be mentioned that the student is not obligated to attend the Vanderbilt School of Medicine. If the application is not
accepted, the rejection is not held against the applicant for future reapplications. For further information, contact Dean John
Lukens at (615) 322-2145.
Early Admission
All U.S. medical schools require a minimum of three years of college work before admission As late as the 1960's, a
sizable portion of the entering class (as many as one-third in some schools) had not received the baccalaureate degree before
matriculation in medical school. With the increased competition for admission to medical school beginning in the late 1960's,
the number of students accepted to matriculate before completion of the baccalaureate has steadily declined until only about one
percent matriculate without a baccalaureate degree. Such students have outstanding personal and academic qualifications.
There may be some question as to why a person with the M.D. degree would wish to obtam a B.S. Aside fmm the
personal satisfaction of obtaining the B.S. degree, there are also good professional reasons for obtaining the degree. Some
graduate schools, for example in public health, will not admit a student even with an earned doctorate unless requirements for a
baccalaureate degree have been completed.
Notification
The Association of American Medical Colleges (AAMC) has so called '`traffic rules" that require member medical
schools to observe certain restrictions for notification of accepted applicants. The earliest notification (other than Early Decision
Program applicants) is October 15. After this date most schools are on a "rolling" notification.
The problem of applicants holding multiple acceptances into late spring and summer has become more acute dming the
past few years. Admissions committees are justifiably concerned when students continue to hold a place m the entering class of
two or more medical schools, with deposits paid and no way for the medical school to know whether or not the accepted applicant
plans to matriculate at their medical school. There is a "domino effect" that often affects several medical schools when one late
decision is made and people move from alternate lists to a place in the class of a school higher on their personal preference list.
To illustrate, several years ago Harvard decided to make a modest increase in their class size durmg the summer by accepting
people fmm their alternate list. When classes began in early fall some medical schools found that their class was not full as a
result of the numerous changes this caused as people "moved up" to accept a position vacated ultimately as a result of Harvard's
decision. Accepted students are justified m holding a place in the class of more than one medical school until they have been
notified about pending financial aid applications, for in many instances such decisions will determine where a student will
matriculate. Once financial aid notification has been made, accepted students should make a prompt decision and then
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immediately withd aw fmm all but the school at which they plan to matriculate. It is unfair to the medical schools concerned
and to those students who are on an alternate list but have no acceptance for some people to continue to hold multiple
acceptances after they have all the information on which to make a decision. Same recent changes in the "traffic rules" require
medical schools to issue a number of acceptances equal to the size of its enming class by March 15. After April 15 students with
complete financial aid information who hold multiple acceptances will be asked to decide an the school at which they will
matriculate and withdraw fmm all other schools. This should help the problem of applicants holding multiple acceptances.
Joint Degree Progra_
Many medical schools offer students the opportunity to earn the M.D. degree plus some other professional degree in a
joint program. The M.D./Ph.D. combined degree program is the one most widely available. One hand ed nine of the U.S.
medical schools offer the option of working simultaneously toward the M.D. and a Ph.D. in a medically related area. The joint
M.D./Ph.D. is usually taken by a person who aspires to a career in academic medicine and will normally require six or seven
years to complete. A student entering such a program ~11 usually take two years of preclinical training with hislher entering
class, then leave the class and take two or three years for completion of the Ph.D. didactic work and much of the Ph.D. research.
After completion of the Ph.D. preliminary examination the student then completes the necessary clinical clerkship m order to
satisfy requirements for the M.D. degree and writes a Ph.D. dissertation.
The National Institute of General Medical Services (an institute in the National Institutes of Health) sponsors a Medical
Scientist Training Program (MSTP) that supports students in M.D./Ph.D. programs at 32 different medical schools.
Approximately 120 new scholarships are awarded each year in this program which pays all tuition fees, plus a stipend of about
$600/month which will provide for basic living costs. There is a "payback" provision in which a student is required to spend one
year of teaching and/or research for each year of support. The competition for MSTP scholarships is very keen. Applicants
should have considerable research experience as well as excellent GPA and MCAT scores to be competitive.
It is also possible to earn a combined M.D./J.D. degree at six different medical schools (Duke, Chicago, Yale, University
of Illinois, Southern Illinois, and the University of Pennsylvania), for persons who wish to combine the study of law and
medicine.
Minorities and Women Applicants
Since the late 1960's U.S. medical schools have greatly increased their efforts toward recruitment of minority students.
Many of the programs which have been initiated are discussed m MEDICAL SCHOOL ADMISSION REQUIREMENTS
Chapter 8, enabled "Ioforruation for Minority Group Students." More complete information is available in the AAMC publication
MINORITY STUDENT OPPORTUNITIES IN U.S. MEDICAL SCHOOLS. Both publications are available in the Health
Professions Advising Of lice. The purpose of such programs is to increase the number of students entering medical school fmm
minorities that are umderrepresented in the medical profession. The AAMC recognizes four groups. This includes African
Americans, Native Americans, Mexican Americans, and Mainland Puerto Ricers.
Some of the programs offered specifically for minority students include special summer programs at many medical
schools which are designed to strengthen the academic background in the sciences as well as provide career information, plus an
introduction to health care for students at the ~mdergraduate level. Certam other summer programs are designed to provide
additional basic science instruction for minority students accepted to enter medical school.
During the early 1970's recruitment of minority students met with considerable success as shown by the fact that the
proportion of traditional minority students in the first-year class rose fmm 4.8 percent in the 1969 enming class to 10.0 percent
m the 1974 entering class. However, in the mid-1970's a decline began in the proportion of minority students enrolled, even
though the actual number of traditional minority students m each entering class remained relatively constant. Recently there has
been some improvement. The 1994 entering class enrolled 2,014 underrepresented minority students comprising 12.4 percent of
the class. The AAMC initiated a program m 1992 called "3000 by 2000," whose purpose is to increase the number of
underrepresented minorities to 3000 by the year 2000. In addition, the AAMC runs a service called The Medical Student
Minority Applicant Registry (Med-MAR) in which students identify themselves as minorities or CQmmg from low-income
families. Two Med-MAR lists are published and distributed to all U.S. medical schools annually.
Minority students contemplating careers in medicine may obtain additional information on financial assistance, special
programs Or minorities and other timely information by writing the Student National Medical Association, Inc., 4400 Stamp
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Road, Suite 208, Temple Hills, Maryland 20748. A source of financial aid available only to traditional minority students is
provided by National Medical Fellowships, Inc., a private philanthropy founded in 1946 which awards several humdred
fellowships each year to needy Black, Chicano, Mainland Puerto Rican, and American Indian medical students. Students with
need for financial aid who can qualify by reason of their raciaUethoic background should request an application from the
Scholarship Program, National Medical Fellowships, 254 West 31~ Street, New York, New York 10001. The completed
application should be returned as soon as an acceptance has been received fmm one medical school even if you are awaiting
responses from other schools. The absolute deadline for applications from entering medical students is August 15.
Considerably better results have been achieved in the recruitment of women students than in recruitment of traditional
minorities. In the 1969 entering class only g.2 percent were female. This number has increased to 42 percent for the 1994
entering class. The percentage of female applicants accepted (based an total number that applied) is now almost exactly the same
as for males. FiHy-eight percent of applicants for admission in 1994 were males. As the statistics verify, women are no longer
considered a minority in medical school.
Accelerated Programs
Several years ago a number of medical schools offered an accelerated program that allowed students to complete
requirements for the M.D. degree in three calendar years. This was accomplished by schethlling classes and clinics throughout
the calendar year in an essentially uninterrupted instructional program timing the three-year period. Information on those
medical schools offering such an option is found in Chapter I O of the MSAR under individual school descriptions. It should be
noted that there has been a decrease in the number of schools offering a three-year program. In 1973, sixteen schools had a
three-year program; in 1976, the number was only nine. It is difficult to determine exactly how many medical schools would
allow a student to complete requirements for the M.D. in less than four years, but many allow considerable flexibility in
scheduling even though they may not have a formal three-year program. These formal accelerated programs have been foumd to
make intense demands on both the students and faculty and many medical educators have questioned whether the saving of one
year in time is worth the added stress.
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CONCLUSIONS
A person reading the preceding sections of these guidelines may conclude that only geniuses survive the program in
premedicine to matriculate into medical school and that they must work most of their waking hours. This is, of course, a great
exaggeration, for many students with only a little better than average ability are admitted to medical school. However, such
students are hard-working, disciplined, very goal-oriented and they have made strong academic records. Students in the
academically gifted category will obviously not have to work as hard to maintain a competitive record and will have more time
for extracurricular activities. The intensity of the competition and the stress sometimes enco~mtered should not be minimized,
but successful students who complete a premedical program at Vanderbilt and are admitted to medical school usually look back
on the four years spent in Athens as among the happiest and most satisfying of their life. Mature students understand that
attainment of such a goal is realized not my by hard work but by good judgment and a proper ordering of priorities. Such
students do not miss out on the football games and other social activities, but they do their work first and play later. Successful
students will make many friends and will have an enjoyable experience as an undergraduate, but they have the added satisfaction
of having made a record that will form the basis of future success. As a person matures it becomes increasingly obvious that real
happiness and true satisfaction come in large part fmm the esteem of peers, which is earned by hard work, high ideals and good
judgment. True satisfaction is not achieved by self-indulgence.
Occasionally a student is encountered with a strong academic record and competitive scores on the MCAT who has been
rejected for admission by several medical schools, including all those where he/she would enjoy preferential consideration. Does
this mean that medical admissions committees are capricious and arbitrary in their selection? In the opinion of the author of this
little treatise, nothing could be father fmm the truth. As a group, medical admissions committees take their enormous
responsibility very seriously. Most com ittees spend humdreds of hours selecting each class. It would be difficult to find a more
dedicated or intellectually honest group. However, we must recognize that admissions com ittees look for the person who will
male the best physician. This is not always the same person who would make the best scientist and not necessarily the person
who is the best student. If applicants were admitted to medical school only on the basis of GPA and MCAT scores, there would
be no need for an admissions committee. The entire class could be chosen by a properly programmed computer.
Traditionally, the ratio between applicants and available positions nationwide has been approximately two. During the
early 1970's there were large increases in the number of applicants to U.S. medical schools and even with the increase in
available spaces mentioned earlier, by 1974 there were 42,624 applicants for 15,066 spaces in the entering class for an
applicant/acceptance ratio of 2.8. In the late 1970's and early 1980's the number of seats in the entering class of U.S. medical
schools increased until a record 16,644 new entrants began the study of medicine in 1981. During the period from 1981 to 1988
the number of applicants decreased from 36,727 to 26,915 to yield an applicant/acceptance ratio of 1.7. During the period 1989
through 1994 the number of applicants again increased, with 45,365 applying for 16,287 seats in the 1994 entering class, for a
ratio of applicants to matriculants of approximately 2.8. The number of applicants for the 1995 entering class was not available at
this writing, but an increase of about 2% has been predicted by officials at the AAMC.
Premedical students should also be aware that medicine rewires a life-long commitment to reaming. Mandatory
continuing education for physicians has become commonplace and more than half the states require continuing medical
education credit for relicensure. The maintenance and expansion of professional competence must, to a large extent, be done by
home study and regular reading of medical journals. Voracious readers are much more likely to have the kinds of skills which
will allow them to keep up with the rapid expansion of knowledge in their field.
Students should also recognize that medical admissions committees seek a broadly educated person who is well-
informed about current events. An entering freshman in premedicine is well advised to subscribe to a weekly news magazine
such as Time or Newsweek (student discounts are available at savings of one half or more) and get into the habit of reading every
issue essentially from cover to cover. The broadly educated person will have an interest in and an awareness of happenings in
many different fields. The relatively low acceptance rate from such fields as medical technology and pharmacy has been
attributed by many observers to the fact that the training in these fields is too narrow and technical.
Most physicians recommend that students cultivate some outside interests which may be pursued for recreation (and
perhaps contribute to physical fitness) during medical school and beyond. It is important to have other interests which may be
used to "get away from it all" occasionally and in this way handle the stress that will be a part of every physician's life. Some
run or play handball, others play musical instruments, paint, or tinker with sports cars. The list is long, but it is important to find
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something that is an enjoyable pastime that can be used to forget about medicine and the problems that may attempt to
overwhelm you.
It is never too soon to begin planning how to pay for your medical education. Students who plan to finance a major part
of their educational costs through loans must be prepared to assume rather large debts. They should also be aware that
management of a large debt while in medical school could limit the type of practice or medical specialty that may be pursued
after completion of training. The heavily indebted graduate may place greater priority on financial rewards rather than type of
practice or specialty when making this decision.
Finally, students should remember that admission is a two-way street. Admissions committees are trymg to find the best
possible candidates to fill their classes and they will actively recruit the type of individual who shows promise of developing into
an outstanding physician. It is hoped that these guidelines will provide information that will be of use in helping each student
develop into the type of candidate that will be actively recruited. We wish you success not only in gaining admission, but also in
your practice and in your persona life. To reiterate a point made earlier, the success of our advising program will be judged by
the success of our students. It is to our mutual benefit that you succeed!
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Appendix
TIMETABLE FOR PREMEDICAL STUDENTS
ù FRESHMAN YEAR Begin the courses that will satisfy requirements for admission to medical school along with the "core"
courses required for graduation. Attend the information meetings that are held for incoming students. Learn early in your
career to keep up with the course work. Develop good study habits and form friendships with serious, motivated students
with whom you can form study groups. Attend Skull & Bones programs to hear from practicing physicians, medical
students and medical admissions recruiters and deans of admission and participate in community service opportunities.
ù SOPHOMORE YEAR Continue taking those courses that are required both for admission to medical school and for your
degree. Make an appointment with the Health Professions Advisor to obtain information, review your overall record, and
begin a file that will be used in preparation of your evaluation summary during the summer after your junior year. Begin
soliciting letters of evaluation from those faculty members who know you well and can finish supportive letters and ratings
for your composite evaluation. Choose your departmental major during the spring.
ù JUNIOR YEAR Complete requirements for admission (and for subjects covered by the MCAT) during the year. Your
academic advisor will now be a faculty member in the department in which you choose to major. He/She will sign your
registration form and help you plan a program of study that will satisfy all reqmrements for graduation. Begin seriously
preparing for the Medical College Admission Test (this is best accomplished by enrolling in the MCAT/DAT Tutorial which
will start the Saturday ailer classes begin for winter quarter.) Register for and take the spring MCAT. Attend the
information meeting held after the MCAT at which AMCAS application forms are distributed and strategy is discussed
regarding your application for admission. Submit information sheet and have on file five letters of evaluation. Check to see
that your folder is complete before leaving for summer break. This must be done for those who will apply under the Early
Decision Program (EDP), and is highly recommended for everyone.
ù SUMMER AFTER THE JUNIOR YEAR Your AMCAS application should be submitted during the summer, before
beginning your senior year. If you apply for admission umder the Early Decision Program the deadline will be August 1.
However, anyone waiting until the approach of a deadline will be at a considerable disadvantage, especially when applying
umder the EDP. If spring MCAT scores are not competitive at the school of your first choice, it will be necessary to retake
this test. To retake the MCAT without careful preparation may harm, not better, your chances.
ù SENIOR YEAR Interviews will begin for those applying under regular application procedures during the fall term of the
senior year. Supplementary application materials must be promptly completed and returned. Confirm that the composite
evaluation was mailed to each medical school at which your application is pending. Interviews continue through the winter
quarter and into the spring quarter at a few schools. Soon alter January 1, you should apply for financial aid. It will be
necessary for you and your parents to submit a needs analysis form, which refigures photocopies of your income tax form for
the previous year. Both you and your parents should promptly file 1040 forms in order to complete this requirement.
Acceptance letters may arrive as early as mid-October, or as late as the week or two after the start of the class (to replace
dropouts). However, those accepted after April will in most cases be from an Ah'=nate List (also called a Wait List). Notify
the Health Professions Advisor of the results of each of your applications before leaving campus in May.
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Appendoc II
SUGGESTED SEQUENCES FOR PREMEDICAL COURSES A T VANDERBIL T
aUGGEmeD 8EIXIEIICE OF SUGGE5rED 8EtlUENCE OF
REQU - ED PRE41ED COURSES REOUReD PRE41ED COUR8ES
_ ~ke} VATH SEI~TER OFF - I
~LLaYBlili - ~
E ~_o Jl_
Fl ~l Cham 102a Chan 102b 1Äa C 1mh
llb Sd 11aa
"W110h 4an220h _E "adllOh Phyei17a
Jt_OR P1~117 F - 117h Ce_ JUNIDR -SÄOII- Plr"117b Con~bb
t ~t t~. ~t
14C~T ~CAT
Ä aEH10R C~bb S~y
D_
1 ~gilERV_
4
SUGGESTED SEGUENCE OF SIJC - S~D SEIWENCE OF
REQLqRED PREYD C ~REIIURED PRE411ED COURSES
VIITH ~IER OFF - a .1TH ~EBTER OFF . Hl
~LL ~EBLL _Ä
FRUH8AN Ch_~ 102a Ct~n 141Zb FR~OÄm 10Q ~Cham 1mb
Bb 8d 110a Bio Sd 110a
81O 8d 110b ~j 117e Plb 117b 81O 8d 110b Chem 790b Fl~a 117b
JU6OR . SÄ_ Olr- SOdy br CÄ~Äa JUIIOR . 8~n_er Off- SbJÄlor C_a
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APPENDIX III
U.S. Medical School Applicants, 1994 Entering Class
(Idstedalphabetically by state, private schools in italics)
Medical Sc}.ooi - Admission Contact-Pnone Number #Class %
Applied SizeIn-state
Un~ Alabama. George Am, Jr., (205) 93~2330 2,494167 79.0
Univ. of South Alabama Marlr Scott, (205) 460~7176 1,630 64 90.6
University of Arizona Dr. Shirley N. Fahey, (602) 626~ff214 1,099 100 100
_
University of Ar~aaIinda W. We, (501) 6B6~354 976 143 979
University of California ~100
Davis Edward Dagang, (91ð) 752-2717 5,199 93
InrineLeah Parker, (714) 86~5388 4,93692 100
L`os~Angeles (UCLA) Dr. Martin Papa, (310) 825~6081 7,94B 168 923
San Diego ~Maria Lodges, (619) 634-3880 5,313 122 95.9
, . .
San FranascoKa1~1een Plesaas, (416) 476~4044 5,325 1!;3 77.8
Loma Linda Unwersib rGA' ~Dr. John Thorn, (909) 8~4467 4,721 169 672
U - ersify of Southern California Arleen Marx, (2i3) 342-2552 5,926 150 87.3
Stanford Univer=ty Dr. Norman Blank, (415) 723-6861 6,39B 86 60.0
Univ~uibr of Colorado Dr. Maureen Gamty, (303) 27~7361 ~3,032 126 84.1
Universe of Connecticut Keat Sanford, (203) 679~2152 2,907 81 65.2
Yde University (CT) Dr. ],lOmaB Lentz, (203) 78~2643 2,837 100 Go
George Washir~ton Uniu. (DC) Dr. John Willis, (202) 99~3506 12,074 157 1.9
Georgetown Univemi~y (Z)C)Karen L. Pfordresher, (202) 687-1164 11,894 185 2.7
Haward Untwrs`ty (DC) Ann Finney, (202) 806 6270 5,878 1~22 9.8
UDiverBil;y of Florida Dr. Linda Lanier, (904) 392~569 3,524 ll5 Ba.3
University of Miami Dr. R.E. Hinkley, (305j 647-6791 2,949 139 90.7
University of South Florida S. Layman, (813) 974~2229 2,1" 96 99.0
Emory U,uversc~ (G4}Rebecca Dilhrd, (404) 727~5660 7,697 114 48.3
Medical College of Georgia Debra Morgan, (706) 721-3186 2,006 180 98.9
Mercer University (GA) Dr. Roger Conmau, (912) 752-2542 1,471 54 100
Morehouse School of Med. (GAJDr. Angela W. Franklin, (404) 752-1650 3,034 34 64.7
Umveraity of Hawaii Marilyn M. Nishik;, (808) 95~5446 1,730 SO.1
Uniuer~t~y of Chicago-Primer Dr. R. Eric Lombard, (312) 702-1938 7,685 104 45.2
Chicago Medical School Dr. Tunot;hy Hansen, (708) 57~3206 11 799 1G4 28.7
35
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U.S. Medical School Applicants, 1994 Entering Class 3
# Claas%
Medical School Admiar,ion Contact-Pbone Number Applied Size In-state
Unner~ty of Curl
Columbia J. McCurdy, (314) 882-2923 1,551 97 97.9
Kaneaa City. MliNnn Tyler, (81fi) 285 1870 89 89 69 7
Saint Louis University PRO). Manuel Coma, (314) 577-8205 - 7,867 151 32.5
Warhing~n University (A{Q)Dr. W. Edwin Dodr,on, (314) 362-6867 6,639 123 8.1
Creighton Unive~y EVE) L. Clara, (402) 280-2798 9,311 112 IS
Unnrer city of Nebraska . Dr. J. Calvin Damr, m, (402) 559 4205 1,7S7 118 S7.5
University of Nevada . ~Dr. Jerry May, (702) 7846063 1,222 52 71.2
. . . .
Dartmouth Medical School Qua H. Malln, (BOO)) ff50-1505 6,459 88 13.ff
USA. of Medicine - New Jersey
New Jersey Medical Dr. George Hednnch, (201) 982~4631 3,814 170 89.4
Robert Wood Jol~nsonDr. Dand Seiden, (908) 235~4576 3,770 188 87.7
Uni~rermty of New Mexico Dr. Diane Pepper, (606) 277-4766 1,422 73 93.2
Albany Medical College avY7 Sara J. Kremer, (618) 262-6621 8, - 6 131 42.8
.
Albert Einstein QVY) . Noreen Kerrigan, (718) 430-2106 7,409 177 44.1
Columbia University (NJ) Dr. Andrew Ed, (212) 305-3595 3,508 150 32.0
Cornell University (IVY) Dr. Gordon Fairdou~h, (212) 746~1067 6,354 101 39.6
Mount Sinai IVY) A. Cohen, (212) 241-6696 7, ~115 58.3
New York Medical College Dr. Edward Brownatein, (914) 993~7 10,982 183 23.0
New York University Ra~nond J. Brienza, (212) 263-5290 4,459 161 50.9
University of Rochester aver Rupp, (716) 275-4539 3,230 98 36.7
State University of New York
SUNY-Brooklyn Alit Montano, (718) 27~2446 5,914 199 90.0
SUNY-Buffalo Dr. Thomas Gutters, (716) 829-3465 3,564 139 99.3
SUNY Stony Brood Gillers, (516) 444~2113 4,02S 100 92.0
SUNY-Syracuse A. Geno Andreatta, (315) 464-4570 S,915 149 92.0
Bowman Gray (1VC) Dr. Lewis Nelson, (910) 71~4264 7,339 108 51.9
Duke University (NC) Dr. Lois Pounds, (919) 684 2986 6,268 100 92.0
East Carolina University. Dean Hayek, (919) 81~2202 1,945 72 100
UDiv. of NC - Chapel Hill Dr. Elizabeth Mann, (919) 962-8331 3,428 160 93.1
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U.S. Medical School Applicants, 1994 Entering Class 4
# Class %
Medical School Admission Contact-Phone N=nber Applied Size Instate
University of North DakotaJudy L. DeMera, (701) 777 4221 282 1 65 1 67 8 -
Case Westen' Reserve (OH)Or. Albert Kirby, (216) 368-3450 7,692 T 136 T 65.4
Univ~i~ of Cinninnati (OH)Clance P. Fook`', (513)- 568-7314 4,979 1 162 1 83.3
Medical College of Ohio. Bard Packards (419) 381-4229 6,193 1 143 | 8L8
Nortbesat~n Ohio Universitiesaren Be~er, (216) 325-2511 1,576 102 95.1
Ohlo State Universityeibert W. Moms, (614) 292,7137 6,442 210 79.5
Wright State University (OH)Dr. Paul Carlaon, (613) 873-2934 - - 3,219 90 86 7
Universi1 y of Ol`}ahomaDr. Nancy Hall (405) 271-2331 1,485 146 87.7
Oregon Health Sciences Univ.Debbie Annus, (503) 494-2998 1,600 93 83.9
*Hahnemann University (PA)Dr. Charles Winkelm~, (215) 762-7600 10,613 171 47.4
Jef7~on Mid College (PA)Dr. Benjamin Bacharach, (215) 955-6983 11,292 223 44.4
Predict CoUege of Pennsylvania. Andrew Beadey, (215) 991-8202 8,682 131 50.4
Pe~vuylvanza StateBrenda Za=, (717) 531-8755 5,416 107 52.3
.
Univenzty of Pennaylvan". Gaye W. Shefiler, (215) 898~001 8,235 150 23.3
.
University of Pittsburgh (PA)Linda Berardi, (412) 64~9891 6,619 140 59.3
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Terrible University (PA):Dr. Moses L. Willis, (215) 707-3656 S,384 1S2 62.1
Brown Univers~t~y (RI)Kathleen Massone, (401) 863~2149 139 ff4 14.1
Medical Univ. of South CarolinaKimberly Meyer, (803j 792-3281 3,276 140 S2.D
Univereity of South CarolinaDr. Robert Sabalis, (803) 733-3325 2,308 73 95.9
UD~ve~ity of South DakotaCayenne Leiser, (605) 677-5233 1,373 50 86.0
East Tennessee State UnivarmlyEdwin D. Taylor, (615) 929~6221 2,231 60 85.0
Meluzrry Medical CoUege (1~Dorm Petwyr, (615) 327-6223 5,548 80 10.0
UDiver~nty of Tennesseeelaon Strother, (901) 448 5659 2,318 166 91.6
Vanderbilt Un~uersity (IN)Dr. John Lulcens, (615) 322-2145 6,400 102 13.7
Baylor College of Medicine (=Dr. Leighton Hill, (713) 798 4841 1,524 167 66.9
.
Texas A & M UrliversityISlomeno Maldonado, (409) 845-7744 1,472 48 100
Texas Tech UniversityDr. James Chappell, (806) 743~3005 1,614 120 06.7
*Medical College of Pennsylvania and Hahnem~nn University School of Medicine have merged.
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U.S. Medical School Applicants, 1994 Entering Class 5
# Class 96
Medical School Admission Contac~Phone Number Applied Size In-atate
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UDiver~nly of Texas
Dallasharlea Kettlew~ill, (214) ~2670 3,128 198 85.4
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Galveston Dr. Billy Ballard, (409) 772-3517 3,066 200 90.5
HouatonSondra Ives, (713) 792 4711 3,173 202 86.6
San Antonio Dr. Leonard Lawrence, (2103 567-2665 3,108 199 87.4
.
Univerai1 y of Utah Dr. Merril Dayton, (801) 581-7498 1,447 100 74.0
UDiverait~r of Vermont Dr. Marga Sprout, (802) ff5~2154 . 6,972 91 38~5
Eastern Virginia Medical School Dr. Robert McComba, (804) 446-6812 5,689 100 62.0
Medical College of ~lrgm~C,mthia Heldberg, (804) 786-9629 4,976 173 68.8
University of Virginia Beth Bailey, (804) 924-5571 5,037 L99 70.5
Univeraity otW~nPatrima Fero, (206) 543-7212 3,901 166 ~SILO
Marshall Universi1 y (WV) Cynibia Warren, (304) 696-7312 1,504 Ä 93.9
University of Weet Virginia. John Traub~t, (304) 293~3521 1,917 88 90.9
Medical College of Wisconsin Leeley A. Maclc, (414) 257-8246 7,615 213 52.1
University of Wisconsin Janice Waisman, (608) 263-4925 . 2,526 143 79.7
Data on 1994 entering -clam from AAMC, Section for Student Services publication FACTS, October 14,
1994. Published with permission of AAMC.
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Appendix V
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Skull & Bones at Vanderbilt University
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Skull & Bones Premedical Society at Vanderbilt
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Shill & Bones members share the common goal of becoming healthcare professionals. The goal of Skull & Bones
Premedical Society at Vanderbilt is to help its members realize this goal within the context of Vanderbilt. S&B provides a
number of services to students in the prehealth sciences, such as sponsoring guest speakers including physicians, medical
educators, medical students, etc., who present informative programs on their particular medical specialty, medical school,
medical research or other topics of interest. In program planning particular emphasis is placed on admissions and community
service. A number of admissions chairmen and committee members f om medical schools will visit the campus each year,
sponsored by Skull & Bones. Past meeting topics have included: Admission to med school MCAT Prep, Interviewing, AMCAS,
Research, Alternatives to medical school Medical School: '~What is it liked', Specialization, MD\PhD, Hot topics in medicine:
AIDS/ Ebola, The Future of Healthcare in America, Literature: Samuel Shem, author of The House of God., Upperclassmen
(intervening and application writing), Early admission at Vanderbilt, and Minorities and Women in medicine among others.
Skull & Bones maintains communication with its members through various means of printed and electronic media including
JVPMS, The Jol~n,~1 of Vanderbilt Premedical Students, S&B-Online (WWW-site), S&B Network E-maiL and various signs
posted around campus
S&B Task Forces
Physicians often posses a variety of interests. The purpose of the S&B Task Forces is to offer premedical students a
chance to focus on specific issues within the greater context of S&B and Vanderbilt. Members are encouraged to participate in at
least 1 of the six Task Forces. Task Force event are held once a month in conjunction with other Vanderbilt offices or student
organizations. 1996-97 S&B Task Forces:
S&B Community Service
Realizing that medicine is a people oriented profession and doctors are community leaders, S&B sponsors various
Community service events throughout the year. Past S&B sponsored community service events have included The Our Kids Soup
Sunday, The Great Music City Rubber Duck Race, AMSA Public Health Initiative '96, The Second Harvest Food Bank, and The
American Red Cross Blood Drive among others. Also, lists of individual volunteer opportunities emphasizing healthcare can be
obtained f om S&B Community Service.
New for 1996-97, S&B will be the first AMSA Premedical chapter in the country to initiate a STATS program
(Students Teaching AIDS to Students). In this program, groups of S&B members who are Certified AIDS trainers with the
American Red Cross ~11 venture into Nashville Metro Schools and teach children f om grades 6-9 about safer sex and
HIV/AIDS prevention. In addition, the program will be extended to Vanderbilt Residence halls, Organizational meetings, etc.
The Shadow Program
Often times, the road to medical school can be unclear. That is why SOB started the Shadow program to match
premedical students will mentors. Upperclassmen (seniors and juniors) will consult and glude underclassmen (sophomores and
f eshmen) about various aspects of premedical education ranging f om which professor to take to study habits. Upperclassmen
will have mentors who are medical school students. Medical students can provide invaluable personal information about the
admissions process and beyond.
Core-Curriculum Tutoring (CCT)
Many premeds encounter problems in classes. In an effort to help Vanderbilt premeds, S&B is sponsoring a tutorial
program. Efforts will be concentrated on requnred courses for acceptance into medical school such as: BSCI 110, Gen Chem 102,
Org Chem 220, Physics 117, and Biochem.
ù For membership information, please contact the HPAO or write to: Skldl & Bones, Attn: I. O. Box #I
41 5(~ ~ ~0,~, - ~1 3(f t3
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Appendix ~
Suggested Readir~gfor Premedical Students
The Best Medical Schools- 1995 Edition: Andrea Nagyand the staff of the Princeton Review c. 1993
This book gives information on each medical school, plus great advice on applications and interviews.
Medical School Admission Reauiremenh: 199~1996 (US and Canada) by the AAMC
A must have! Tellsyou exactly what courses are requiredfor each med. school.
Barron's Guide to Medical and Dental Schools: Dr. Saul Wischnitzer c. 1993.
A guide to all medical schools and dental schools.
REA's Authoritative Guide to Medical and Dental Schools. c. 1995
Another guide to ad medical schools and dental schools.
Getting into Medical School: Strategies for the 90~ Plantz, MD. c. 1993.
Another must have! Gives great, comprehensive advice for your entire college career.
The Premedical Planning Guide. Williams and Wilkins: The Science of Review. c. 1994
Good advice on entire college career.
Mastering Medicine- 1995-1996: Zia Hashemi, M.D. c.1995
This book will show you how to Plan, Prepare, and Succeed.
The Definitive Guide to Medical School Admission. Goldstein and Goldstein: c. 1996
A must have for aspiring Ambitious young adults entering the medical profession.
How To Get Into The Bight Medical School: Calla S. Rogers, Ph.D. c. 1996.
This book guidesyou through all the steps in getting into the 'right' medical school.
42
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